How much rates vary
Facilitymedian $4,786 · 10th to 90th $977 to $12,589Professionalmedian $1,000 · 10th to 90th $813 to $1,445
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 $977.24 Median $5,623.41 Typical High $10,964.78 | Facility | None | $977.24 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,412.54 | Professional | None | $977.24 | $977.24 | $1,412.54 |
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 $870.96 Median $1,047.13 Typical High $1,258.93 | Professional | None | $870.96 | $1,047.13 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $199.53 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $144.54 Typical High $173.78 | Professional | AS · PA/NP assist | $120.23 | $144.54 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,348.96 | Professional | None | $912.01 | $1,023.29 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $7,079.46 | Facility | None | $645.65 | $3,311.31 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,445.44 | Professional | None | $831.76 | $933.25 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,318.26 | Professional | None | $870.96 | $1,047.13 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,621.81 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,584.89 | Facility | None | $977.24 | $1,148.15 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,698.24 | Professional | None | $912.01 | $1,071.52 | $1,698.24 |
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 $891.25 Median $1,096.48 Typical High $2,187.76 | Professional | None | $891.25 | $1,096.48 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,698.24 | Professional | None | $630.96 | $870.96 | $1,698.24 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $691.83 |
Where Virginia sits
The same service costs 4.2 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 $12,508MT $2,994
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.