How much rates vary
Facilitymedian $4,365 · 10th to 90th $851 to $10,965Professionalmedian $912 · 10th to 90th $724 to $1,259
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 $912.01 Median $5,623.41 Typical High $10,964.78 | Facility | None | $912.01 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,258.93 | Professional | None | $851.14 | $912.01 | $1,258.93 |
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 $758.58 Median $912.01 Typical High $1,096.48 | Professional | None | $758.58 | $912.01 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,380.38 Typical High $1,659.59 | Professional | 50 · Both sides | $1,148.15 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $691.83 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $177.83 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,174.90 | Professional | None | $812.83 | $912.01 | $1,174.90 |
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 $758.58 Median $831.76 Typical High $1,258.93 | Professional | None | $758.58 | $831.76 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,096.48 | Professional | None | $741.31 | $870.96 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,258.93 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,479.11 | Facility | None | $912.01 | $1,047.13 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $10,232.93 | Facility | None | $691.83 | $2,187.76 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,949.84 | Professional | None | $707.95 | $954.99 | $1,949.84 |
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 $562.34 Median $724.44 Typical High $1,479.11 | Professional | None | $562.34 | $724.44 | $1,479.11 |
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 $426.58 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $426.58 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $630.96 |
Where Virginia sits
The same service costs 3.1 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 $8,115MD $2,591
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.