How much rates vary
Facilitymedian $5,495 · 10th to 90th $933 to $14,125Professionalmedian $933 · 10th to 90th $741 to $1,349
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,148.15 Median $5,495.41 Typical High $11,481.54 | Facility | None | $1,148.15 | $5,495.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,479.11 | Professional | None | $851.14 | $933.25 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | None | $776.25 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,380.38 Typical High $1,659.59 | Professional | 50 · Both sides | $1,174.90 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $588.84 Typical High $707.95 | Professional | 62 · Two surgeons | $489.78 | $588.84 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $177.83 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $154.88 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,202.26 | Professional | None | $812.83 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $7,079.46 | Facility | None | $724.44 | $3,467.37 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,288.25 | Professional | None | $776.25 | $831.76 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | None | $741.31 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,548.82 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,513.56 | Facility | None | $933.25 | $1,096.48 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,174.90 | $1,230.27 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $11,481.54 | Facility | None | $851.14 | $2,238.72 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,949.84 | Professional | None | $812.83 | $1,023.29 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,513.56 | Professional | None | $575.44 | $776.25 | $1,513.56 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $426.58 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $645.65 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $645.65 |
Where Virginia sits
The same service costs 5.9 times more in Colorado than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $14,031WV $2,390
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.