How much rates vary
Facilitymedian $3,802 · 10th to 90th $724 to $10,965Professionalmedian $724 · 10th to 90th $589 to $1,023
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 $891.25 Median $4,786.30 Typical High $9,332.54 | Facility | None | $891.25 | $4,786.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,071.52 | Professional | None | $676.08 | $724.44 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $870.96 | Professional | None | $616.60 | $741.31 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $1,318.26 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $141.25 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $123.03 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $954.99 | Professional | None | $645.65 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $1,023.29 | Professional | None | $602.56 | $660.69 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $891.25 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $724.44 Median $851.14 Typical High $1,174.90 | Facility | None | $724.44 | $851.14 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $954.99 | Professional | None | $794.33 | $851.14 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $630.96 Median $1,819.70 Typical High $10,232.93 | Facility | None | $630.96 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,548.82 | Professional | None | $645.65 | $758.58 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,174.90 | Professional | None | $446.68 | $588.84 | $1,174.90 |
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 $338.84 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $478.63 | $501.19 | $501.19 |
Where Virginia sits
The same service costs 3.7 times more in Wisconsin 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
WI $7,647MT $2,070
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.