How much rates vary
Facilitymedian $3,162 · 10th to 90th $479 to $9,550Professionalmedian $427 · 10th to 90th $324 to $794
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 $575.44 Median $4,073.80 Typical High $9,332.54 | Facility | None | $575.44 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $707.95 | Professional | None | $363.08 | $575.44 | $707.95 |
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 $323.59 Median $389.05 Typical High $467.74 | Professional | None | $323.59 | $389.05 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $575.44 Typical High $707.95 | Professional | 50 · Both sides | $489.78 | $575.44 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $61.66 Typical High $74.13 | Professional | 80 · Assistant surgeon | $51.29 | $61.66 | $74.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $53.70 Typical High $66.07 | Professional | AS · PA/NP assist | $45.71 | $53.70 | $66.07 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $489.78 | Professional | None | $338.84 | $380.19 | $489.78 |
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 $338.84 Median $512.86 Typical High $794.33 | Professional | None | $338.84 | $512.86 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $794.33 | Professional | None | $524.81 | $616.60 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $851.14 | Professional | None | $660.69 | $831.76 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $676.08 Typical High $1,174.90 | Facility | None | $446.68 | $676.08 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $794.33 | Professional | None | $457.09 | $660.69 | $794.33 |
Sentara Setting Facility Modifier None Typical Low $346.74 Median $1,479.11 Typical High $8,709.64 | Facility | None | $346.74 | $1,479.11 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,479.11 | Professional | None | $537.03 | $707.95 | $1,479.11 |
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 $281.84 Median $489.78 Typical High $977.24 | Professional | None | $281.84 | $489.78 | $977.24 |
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 $181.97 Median $257.04 Typical High $354.81 | Professional | 52 · Reduced service | $181.97 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $104.71 Typical High $141.25 | Professional | 53 · Discontinued | $72.44 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $537.03 | Professional | 54 · Surgery only | $275.42 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $77.62 Typical High $107.15 | Professional | 55 · Aftercare only | $54.95 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $51.29 Typical High $70.79 | Professional | 56 · Pre-op care only | $36.31 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $363.08 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $257.04 | $363.08 | $501.19 |
Where Virginia sits
The same service costs 4.4 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 $6,451MT $1,460
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.