How much rates vary
Facilitymedian $2,138 · 10th to 90th $575 to $6,918Professionalmedian $676 · 10th to 90th $525 to $933
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 $691.83 Median $5,370.32 Typical High $10,000.00 | Facility | None | $691.83 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $912.01 | Professional | None | $645.65 | $691.83 | $912.01 |
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 $575.44 Median $691.83 Typical High $831.76 | Professional | None | $575.44 | $691.83 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,047.13 Typical High $1,258.93 | Professional | 50 · Both sides | $870.96 | $1,047.13 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $436.52 Typical High $524.81 | Professional | 62 · Two surgeons | $363.08 | $436.52 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $131.83 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $97.72 Typical High $117.49 | Professional | AS · PA/NP assist | $81.28 | $97.72 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $891.25 | Professional | None | $616.60 | $676.08 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,318.26 Typical High $2,691.53 | Facility | None | $524.81 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $933.25 | Professional | None | $537.03 | $630.96 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $851.14 | Professional | None | $562.34 | $676.08 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | None | $602.56 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $1,122.02 | Facility | None | $616.60 | $616.60 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | None | $630.96 | $630.96 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,148.15 Typical High $3,630.78 | Facility | None | $501.19 | $1,148.15 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,445.44 | Professional | None | $512.86 | $691.83 | $1,445.44 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $1,096.48 | Professional | None | $407.38 | $549.54 | $1,096.48 |
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 $316.23 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $478.63 |
Where Virginia sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,475DE $1,401
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.