How much rates vary
Facilitymedian $3,236 · 10th to 90th $513 to $10,965Professionalmedian $479 · 10th to 90th $389 to $692
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 $501.19 Median $3,801.89 Typical High $9,332.54 | Facility | None | $501.19 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $851.14 | Professional | None | $436.52 | $478.63 | $851.14 |
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 $398.11 Median $478.63 Typical High $575.44 | Professional | None | $398.11 | $478.63 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $302.00 Typical High $363.08 | Professional | 62 · Two surgeons | $251.19 | $302.00 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $616.60 | Professional | None | $426.58 | $478.63 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $691.83 | Professional | None | $407.38 | $436.52 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $588.84 | Professional | None | $398.11 | $478.63 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | None | $602.56 | $741.31 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $776.25 | Facility | None | $478.63 | $575.44 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $660.69 | Professional | None | $501.19 | $524.81 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $416.87 Median $1,737.80 Typical High $10,232.93 | Facility | None | $416.87 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $1,023.29 | Professional | None | $416.87 | $524.81 | $1,023.29 |
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 $295.12 Median $398.11 Typical High $776.25 | Professional | None | $295.12 | $398.11 | $776.25 |
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 $218.78 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $218.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $331.13 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $331.13 |
Where Virginia sits
The same service costs 5.1 times more in Wisconsin 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
WI $7,097MT $1,384
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.