How much rates vary
Facilitymedian $5,888 · 10th to 90th $891 to $14,125Professionalmedian $813 · 10th to 90th $661 to $1,202
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 $812.83 Median $5,623.41 Typical High $10,964.78 | Facility | None | $812.83 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,445.44 | Professional | None | $758.58 | $812.83 | $1,445.44 |
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 $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $512.86 Typical High $616.60 | Professional | 62 · Two surgeons | $426.58 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $154.88 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,047.13 | Professional | None | $724.44 | $812.83 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $954.99 | Professional | None | $645.65 | $776.25 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,318.26 | Facility | None | $812.83 | $1,000.00 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,621.81 | Professional | None | $933.25 | $1,047.13 | $1,621.81 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $10,232.93 | Facility | None | $741.31 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,698.24 | Professional | None | $724.44 | $977.24 | $1,698.24 |
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 $501.19 Median $691.83 Typical High $1,445.44 | Professional | None | $501.19 | $691.83 | $1,445.44 |
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 $380.19 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $562.34 |
Where Virginia sits
The same service costs 4.4 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 $9,724MT $2,195
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.