How much rates vary
Facilitymedian $5,623 · 10th to 90th $851 to $15,849Professionalmedian $832 · 10th to 90th $676 to $1,175
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 $851.14 Median $5,370.32 Typical High $10,000.00 | Facility | None | $851.14 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,174.90 | Professional | None | $794.33 | $851.14 | $1,174.90 |
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 $851.14 Typical High $1,023.29 | Professional | None | $707.95 | $851.14 | $1,023.29 |
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 $537.03 Typical High $645.65 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $645.65 |
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 $812.83 Typical High $1,071.52 | Professional | None | $741.31 | $812.83 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $9,120.11 | Facility | None | $524.81 | $3,019.95 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,202.26 | Professional | None | $707.95 | $741.31 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $977.24 | Professional | None | $660.69 | $794.33 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Facility | None | $851.14 | $1,000.00 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,148.15 | Professional | None | $933.25 | $1,071.52 | $1,148.15 |
Sentara Setting Facility Modifier None Typical Low $707.95 Median $2,454.71 Typical High $12,882.50 | Facility | None | $707.95 | $2,454.71 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,819.70 | Professional | None | $758.58 | $933.25 | $1,819.70 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,380.38 | Professional | None | $537.03 | $707.95 | $1,380.38 |
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 $398.11 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $169.82 | $169.82 |
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 $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $85.11 |
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 6.0 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 $14,230MT $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.