How much rates vary
Facilitymedian $4,365 · 10th to 90th $955 to $10,965Professionalmedian $1,000 · 10th to 90th $794 to $1,413
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 $1,000.00 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,000.00 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,380.38 | Professional | None | $954.99 | $1,000.00 | $1,380.38 |
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 $851.14 Median $1,023.29 Typical High $1,230.27 | Professional | None | $851.14 | $1,023.29 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $162.18 Typical High $194.98 | Professional | 80 · Assistant surgeon | $134.90 | $162.18 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $891.25 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,235.94 | Facility | None | $645.65 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,412.54 | Professional | None | $831.76 | $912.01 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,230.27 | Professional | None | $831.76 | $1,000.00 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,548.82 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,096.48 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,862.09 | Professional | None | $933.25 | $1,023.29 | $1,862.09 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $10,232.93 | Facility | None | $851.14 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,137.96 | Professional | None | $870.96 | $1,071.52 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,621.81 | Professional | None | $616.60 | $851.14 | $1,621.81 |
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 $467.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $707.95 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $660.69 | $691.83 | $691.83 |
Where Virginia sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.