How much rates vary
Facilitymedian $2,291 · 10th to 90th $437 to $9,120Professionalmedian $389 · 10th to 90th $309 to $676
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 $457.09 Median $707.95 Typical High $8,317.64 | Facility | None | $457.09 | $707.95 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $758.58 | Professional | None | $338.84 | $524.81 | $758.58 |
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 $309.03 Median $371.54 Typical High $446.68 | Professional | None | $309.03 | $371.54 | $446.68 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $234.42 Typical High $281.84 | Professional | 62 · Two surgeons | $194.98 | $234.42 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $478.63 | Professional | None | $323.59 | $363.08 | $478.63 |
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 $323.59 Median $457.09 Typical High $707.95 | Professional | None | $323.59 | $457.09 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | None | $489.78 | $588.84 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | None | $512.86 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $912.01 | Facility | None | $363.08 | $562.34 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $676.08 | Professional | None | $467.74 | $549.54 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $1,445.44 Typical High $8,709.64 | Facility | None | $316.23 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,202.26 | Professional | None | $398.11 | $549.54 | $1,202.26 |
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 $251.19 Median $407.38 Typical High $758.58 | Professional | None | $251.19 | $407.38 | $758.58 |
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 $169.82 Median $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $169.82 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $67.61 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $257.04 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $51.29 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.88 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $239.88 | $323.59 | $389.05 |
Where Virginia sits
The same service costs 6.4 times more in Colorado than in West Virginia. 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 $6,390WV $1,003
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.