How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,096 to $9,550Professionalmedian $1,175 · 10th to 90th $955 to $1,660
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 $1,174.90 Median $5,248.07 Typical High $10,000.00 | Facility | None | $1,174.90 | $5,248.07 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,174.90 | $1,621.81 |
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 $1,000.00 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,174.90 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 80 · Assistant surgeon | $158.49 | $190.55 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $199.53 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,174.90 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,548.13 | Facility | None | $707.95 | $1,445.44 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,071.52 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,412.54 | Professional | None | $933.25 | $1,122.02 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,778.28 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,949.84 | Facility | None | $1,174.90 | $1,445.44 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,348.96 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $8,709.64 | Facility | None | $933.25 | $1,819.70 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,258.93 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,905.46 | Professional | None | $741.31 | $1,023.29 | $1,905.46 |
2 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 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $831.76 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $831.76 |
Where Virginia sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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 $8,126KY $2,271
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.