How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,175 to $14,791Professionalmedian $1,175 · 10th to 90th $977 to $1,698
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 $1,479.11 Median $5,495.41 Typical High $15,488.17 | Facility | None | $1,479.11 | $5,495.41 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,174.90 | $1,819.70 |
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 $1,000.00 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,187.76 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $912.01 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $229.09 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,174.90 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $7,079.46 | Facility | None | $1,000.00 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,071.52 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,412.54 | Professional | None | $933.25 | $1,122.02 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,862.09 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,949.84 | Facility | None | $1,174.90 | $1,412.54 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,659.59 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $11,481.54 | Facility | None | $933.25 | $2,454.71 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,288.25 | $2,570.40 |
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 $741.31 Median $977.24 Typical High $1,949.84 | Professional | None | $741.31 | $977.24 | $1,949.84 |
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 $549.54 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $549.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $831.76 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $831.76 |
Where Virginia sits
The same service costs 4.2 times more in Colorado than in Montana. 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 $14,362MT $3,396
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.