How much rates vary
Facilitymedian $3,890 · 10th to 90th $646 to $11,220Professionalmedian $617 · 10th to 90th $513 to $912
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 $4,365.16 Typical High $14,125.38 | Facility | None | $645.65 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,096.48 | Professional | None | $575.44 | $645.65 | $1,096.48 |
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 $512.86 Median $616.60 Typical High $741.31 | Professional | None | $512.86 | $616.60 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | 50 · Both sides | $776.25 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $97.72 Typical High $117.49 | Professional | 80 · Assistant surgeon | $83.18 | $97.72 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $87.10 Typical High $104.71 | Professional | AS · PA/NP assist | $72.44 | $87.10 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $794.33 | Professional | None | $549.54 | $602.56 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,819.70 Typical High $3,090.30 | Facility | None | $524.81 | $1,819.70 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $870.96 | Professional | None | $537.03 | $562.34 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $741.31 | Professional | None | $501.19 | $602.56 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | None | $776.25 | $977.24 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $741.31 Typical High $1,047.13 | Facility | None | $645.65 | $741.31 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $831.76 | Professional | None | $691.83 | $831.76 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $10,232.93 | Facility | None | $537.03 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,348.96 | Professional | None | $549.54 | $707.95 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $1,047.13 | Professional | None | $407.38 | $524.81 | $1,047.13 |
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 $288.40 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $446.68 |
Where Virginia sits
The same service costs 4.7 times more in Connecticut 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
CT $8,304MT $1,762
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.