How much rates vary
Facilitymedian $6,607 · 10th to 90th $813 to $15,849Professionalmedian $813 · 10th to 90th $661 to $1,175
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 $776.25 Median $812.83 Typical High $1,122.02 | Professional | None | $776.25 | $812.83 | $1,122.02 |
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 $691.83 Median $831.76 Typical High $1,000.00 | Professional | None | $691.83 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $1,479.11 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $524.81 Typical High $630.96 | Professional | 62 · Two surgeons | $436.52 | $524.81 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $158.49 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $138.04 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,071.52 | Professional | None | $741.31 | $812.83 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $9,772.37 | Facility | None | $645.65 | $3,311.31 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,148.15 | Professional | None | $691.83 | $758.58 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $977.24 | Professional | None | $645.65 | $776.25 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $977.24 Typical High $1,348.96 | Facility | None | $812.83 | $977.24 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | None | $912.01 | $1,071.52 | $1,122.02 |
Sentara Setting Facility Modifier None Typical Low $724.44 Median $2,454.71 Typical High $12,882.50 | Facility | None | $724.44 | $2,454.71 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,737.80 | Professional | None | $741.31 | $912.01 | $1,737.80 |
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 $512.86 Median $676.08 Typical High $1,318.26 | Professional | None | $512.86 | $676.08 | $1,318.26 |
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 $389.05 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $575.44 |
Where Virginia sits
The same service costs 6.2 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 $14,513MT $2,350
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.