How much rates vary
Facilitymedian $3,802 · 10th to 90th $525 to $10,965Professionalmedian $490 · 10th to 90th $380 to $832
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 $645.65 Median $4,897.79 Typical High $10,964.78 | Facility | None | $645.65 | $4,897.79 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $870.96 | Professional | None | $416.87 | $645.65 | $870.96 |
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 $389.05 Median $457.09 Typical High $562.34 | Professional | None | $389.05 | $457.09 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $691.83 Typical High $831.76 | Professional | 50 · Both sides | $575.44 | $691.83 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $288.40 Typical High $354.81 | Professional | 62 · Two surgeons | $245.47 | $288.40 | $354.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $74.13 Typical High $89.13 | Professional | 80 · Assistant surgeon | $61.66 | $74.13 | $89.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $64.57 Typical High $77.62 | Professional | AS · PA/NP assist | $53.70 | $64.57 | $77.62 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $588.84 | Professional | None | $407.38 | $446.68 | $588.84 |
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 $407.38 Median $588.84 Typical High $870.96 | Professional | None | $407.38 | $588.84 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $933.25 | Professional | None | $616.60 | $741.31 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $691.83 Typical High $1,122.02 | Facility | None | $457.09 | $691.83 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $707.95 | Professional | None | $562.34 | $575.44 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $1,513.56 Typical High $8,709.64 | Facility | None | $380.19 | $1,513.56 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,445.44 | Professional | None | $467.74 | $691.83 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,489.63 | Facility | None | $1,230.27 | $5,011.87 | $13,489.63 |
United Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $954.99 | Professional | None | $309.03 | $512.86 | $954.99 |
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 $208.93 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $208.93 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $83.18 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $316.23 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $63.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $41.69 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $295.12 | $407.38 | $489.78 |
Where Virginia sits
The same service costs 6.5 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 $9,949MT $1,532
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.