How much rates vary
Facilitymedian $3,715 · 10th to 90th $776 to $10,965Professionalmedian $741 · 10th to 90th $589 to $1,072
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 $933.25 Median $3,981.07 Typical High $9,332.54 | Facility | None | $933.25 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,258.93 | Professional | None | $676.08 | $741.31 | $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 $616.60 Median $741.31 Typical High $891.25 | Professional | None | $616.60 | $741.31 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,096.48 Typical High $1,318.26 | Professional | 50 · Both sides | $933.25 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $467.74 Typical High $562.34 | Professional | 62 · Two surgeons | $389.05 | $467.74 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,659.59 Typical High $3,090.30 | Facility | None | $478.63 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $1,096.48 | Professional | None | $630.96 | $676.08 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $870.96 | Professional | None | $588.84 | $707.95 | $870.96 |
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 $741.31 Median $912.01 Typical High $1,230.27 | Facility | None | $741.31 | $912.01 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,548.82 | Professional | None | $851.14 | $977.24 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $1,819.70 Typical High $10,232.93 | Facility | None | $676.08 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,584.89 | Professional | None | $660.69 | $891.25 | $1,584.89 |
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 $467.74 Median $630.96 Typical High $1,230.27 | Professional | None | $467.74 | $630.96 | $1,230.27 |
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 $338.84 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $524.81 |
Where Virginia sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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 $7,283HI $2,091
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.