How much rates vary
Facilitymedian $5,495 · 10th to 90th $813 to $14,791Professionalmedian $759 · 10th to 90th $617 to $1,122
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 $758.58 Median $5,370.32 Typical High $14,125.38 | Facility | None | $758.58 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,348.96 | Professional | None | $707.95 | $758.58 | $1,348.96 |
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 $645.65 Median $776.25 Typical High $912.01 | Professional | None | $645.65 | $776.25 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,148.15 Typical High $1,380.38 | Professional | 50 · Both sides | $954.99 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $123.03 Typical High $147.91 | Professional | 80 · Assistant surgeon | $102.33 | $123.03 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $107.15 Typical High $128.82 | Professional | AS · PA/NP assist | $89.13 | $107.15 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,000.00 | Professional | None | $676.08 | $758.58 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $8,912.51 | Facility | None | $524.81 | $3,019.95 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $1,174.90 | Professional | None | $645.65 | $691.83 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | None | $602.56 | $724.44 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $1,230.27 | Facility | None | $758.58 | $954.99 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,000.00 | Professional | None | $870.96 | $977.24 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $707.95 Median $2,137.96 Typical High $12,882.50 | Facility | None | $707.95 | $2,137.96 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,621.81 | Professional | None | $676.08 | $912.01 | $1,621.81 |
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 $467.74 Median $660.69 Typical High $1,380.38 | Professional | None | $467.74 | $660.69 | $1,380.38 |
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 $354.81 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $524.81 |
Where Virginia sits
The same service costs 6.4 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 $13,837MT $2,168
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.