How much rates vary
Facilitymedian $2,630 · 10th to 90th $363 to $9,550Professionalmedian $302 · 10th to 90th $245 to $479
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 $389.05 Median $2,818.38 Typical High $9,332.54 | Facility | None | $389.05 | $2,818.38 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $549.54 | Professional | None | $281.84 | $316.23 | $549.54 |
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 $251.19 Median $302.00 Typical High $363.08 | Professional | None | $251.19 | $302.00 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $457.09 Typical High $549.54 | Professional | 50 · Both sides | $380.19 | $457.09 | $549.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 62 · Two surgeons | $158.49 | $190.55 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $389.05 | Professional | None | $269.15 | $302.00 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,621.81 Typical High $3,090.30 | Facility | None | $346.74 | $1,621.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $478.63 | Professional | None | $269.15 | $275.42 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $363.08 | Professional | None | $245.47 | $295.12 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $776.25 | Professional | None | $416.87 | $524.81 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $389.05 Typical High $512.86 | Facility | None | $316.23 | $389.05 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $436.52 | Professional | None | $354.81 | $363.08 | $436.52 |
Sentara Setting Facility Modifier None Typical Low $288.40 Median $1,258.93 Typical High $8,709.64 | Facility | None | $288.40 | $1,258.93 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $676.08 | Professional | None | $281.84 | $380.19 | $676.08 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $524.81 | Professional | None | $194.98 | $269.15 | $524.81 |
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 $141.25 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $218.78 |
Where Virginia sits
The same service costs 7.3 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 $6,269MT $863
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.