How much rates vary
Facilitymedian $5,370 · 10th to 90th $794 to $15,488Professionalmedian $794 · 10th to 90th $646 to $1,148
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 $794.33 Median $3,981.07 Typical High $9,332.54 | Facility | None | $794.33 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,288.25 | Professional | None | $741.31 | $794.33 | $1,288.25 |
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 $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,202.26 Typical High $1,445.44 | Professional | 50 · Both sides | $1,000.00 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $616.60 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $134.90 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,047.13 | Professional | None | $707.95 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $9,120.11 | Facility | None | $524.81 | $3,019.95 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,122.02 | Professional | None | $676.08 | $724.44 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $954.99 | Professional | None | $645.65 | $776.25 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,202.26 | Professional | None | $954.99 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $933.25 Typical High $1,318.26 | Facility | None | $794.33 | $933.25 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | None | $870.96 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $2,454.71 Typical High $11,481.54 | Facility | None | $676.08 | $2,454.71 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,698.24 | Professional | None | $691.83 | $870.96 | $1,698.24 |
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 $501.19 Median $645.65 Typical High $1,288.25 | Professional | None | $501.19 | $645.65 | $1,288.25 |
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 $371.54 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $562.34 |
Where Virginia sits
The same service costs 6.1 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 $13,882MT $2,270
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.