How much rates vary
Facilitymedian $4,786 · 10th to 90th $832 to $13,804Professionalmedian $832 · 10th to 90th $676 to $1,202
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 $1,047.13 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,047.13 | $4,466.84 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,513.56 | Professional | None | $776.25 | $831.76 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | None | $707.95 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $1,513.56 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $524.81 Typical High $630.96 | Professional | 62 · Two surgeons | $446.68 | $524.81 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $141.25 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,071.52 | Professional | None | $741.31 | $831.76 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $7,079.46 | Facility | None | $645.65 | $3,311.31 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,202.26 | Professional | None | $707.95 | $758.58 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,023.29 | Professional | None | $676.08 | $812.83 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $977.24 Typical High $1,380.38 | Facility | None | $831.76 | $977.24 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $954.99 Typical High $1,096.48 | Professional | None | $933.25 | $954.99 | $1,096.48 |
Sentara Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $10,232.93 | Facility | None | $691.83 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,778.28 | Professional | None | $741.31 | $891.25 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,348.96 | Professional | None | $524.81 | $691.83 | $1,348.96 |
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 $389.05 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $588.84 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $588.84 |
Where Virginia sits
The same service costs 5.7 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 $13,613MT $2,377
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.