How much rates vary
Facilitymedian $5,248 · 10th to 90th $933 to $15,488Professionalmedian $955 · 10th to 90th $794 to $1,445
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 $954.99 Median $3,801.89 Typical High $9,332.54 | Facility | None | $954.99 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,621.81 | Professional | None | $912.01 | $954.99 | $1,621.81 |
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 $831.76 Median $1,000.00 Typical High $1,174.90 | Professional | None | $831.76 | $1,000.00 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | 50 · Both sides | $1,230.27 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $741.31 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $190.55 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $165.96 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,258.93 | Professional | None | $870.96 | $977.24 | $1,258.93 |
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 $794.33 Median $891.25 Typical High $1,348.96 | Professional | None | $794.33 | $891.25 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,202.26 | Professional | None | $794.33 | $954.99 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,584.89 | Facility | None | $954.99 | $1,122.02 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,148.15 | Professional | None | $1,047.13 | $1,071.52 | $1,148.15 |
Sentara Setting Facility Modifier None Typical Low $831.76 Median $2,454.71 Typical High $11,481.54 | Facility | None | $831.76 | $2,454.71 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $2,089.30 | Professional | None | $870.96 | $1,047.13 | $2,089.30 |
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 $602.56 Median $794.33 Typical High $1,584.89 | Professional | None | $602.56 | $794.33 | $1,584.89 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
Where Virginia sits
The same service costs 5.5 times more in Colorado 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
CO $14,085HI $2,567
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.