How much rates vary
Facilitymedian $5,370 · 10th to 90th $646 to $15,488Professionalmedian $617 · 10th to 90th $490 to $891
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 $616.60 Median $3,801.89 Typical High $10,471.29 | Facility | None | $616.60 | $3,801.89 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,047.13 | Professional | None | $588.84 | $616.60 | $1,047.13 |
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 $537.03 Median $645.65 Typical High $776.25 | Professional | None | $537.03 | $645.65 | $776.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $407.38 Typical High $489.78 | Professional | 62 · Two surgeons | $338.84 | $407.38 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $831.76 | Professional | None | $562.34 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $8,912.51 | Facility | None | $645.65 | $3,311.31 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $851.14 | Professional | None | $501.19 | $575.44 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $794.33 | Professional | None | $524.81 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | None | $602.56 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $691.83 Typical High $1,000.00 | Facility | None | $616.60 | $691.83 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $660.69 | Professional | None | $537.03 | $549.54 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $2,041.74 Typical High $10,715.19 | Facility | None | $426.58 | $2,041.74 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $1,318.26 | Professional | None | $426.58 | $630.96 | $1,318.26 |
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 $371.54 Median $489.78 Typical High $1,000.00 | Professional | None | $371.54 | $489.78 | $1,000.00 |
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 $295.12 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $416.87 | $426.58 | $426.58 |
Where Virginia sits
The same service costs 7.5 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 $13,659MT $1,825
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.