How much rates vary
Facilitymedian $5,370 · 10th to 90th $708 to $15,488Professionalmedian $692 · 10th to 90th $575 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 $870.96 Median $4,365.16 Typical High $9,332.54 | Facility | None | $870.96 | $4,365.16 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,258.93 | Professional | None | $660.69 | $691.83 | $1,258.93 |
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 $602.56 Median $707.95 Typical High $851.14 | Professional | None | $602.56 | $707.95 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,071.52 Typical High $1,288.25 | Professional | 50 · Both sides | $891.25 | $1,071.52 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $446.68 Typical High $537.03 | Professional | 62 · Two surgeons | $380.19 | $446.68 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | 80 · Assistant surgeon | $95.50 | $114.82 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $100.00 Typical High $120.23 | Professional | AS · PA/NP assist | $83.18 | $100.00 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $933.25 | Professional | None | $630.96 | $707.95 | $933.25 |
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 $588.84 Median $645.65 Typical High $977.24 | Professional | None | $588.84 | $645.65 | $977.24 |
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 $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | None | $912.01 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $812.83 Typical High $1,148.15 | Facility | None | $691.83 | $812.83 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $954.99 | Professional | None | $758.58 | $794.33 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $11,481.54 | Facility | None | $645.65 | $2,290.87 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,479.11 | Professional | None | $630.96 | $776.25 | $1,479.11 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $1,148.15 | Professional | None | $436.52 | $588.84 | $1,148.15 |
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 $331.13 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $489.78 |
Where Virginia sits
The same service costs 6.8 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 $13,753MT $2,023
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.