How much rates vary
Facilitymedian $4,365 · 10th to 90th $617 to $11,220Professionalmedian $589 · 10th to 90th $479 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 $1,047.13 Median $5,623.41 Typical High $15,488.17 | Facility | None | $1,047.13 | $5,623.41 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $851.14 | Professional | None | $562.34 | $588.84 | $851.14 |
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 $501.19 Median $602.56 Typical High $724.44 | Professional | None | $501.19 | $602.56 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $891.25 Typical High $1,071.52 | Professional | 50 · Both sides | $741.31 | $891.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $380.19 Typical High $457.09 | Professional | 62 · Two surgeons | $316.23 | $380.19 | $457.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | 80 · Assistant surgeon | $79.43 | $95.50 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $83.18 Typical High $100.00 | Professional | AS · PA/NP assist | $69.18 | $83.18 | $100.00 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $758.58 | Professional | None | $524.81 | $588.84 | $758.58 |
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 $501.19 Median $537.03 Typical High $812.83 | Professional | None | $501.19 | $537.03 | $812.83 |
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 $724.44 Median $912.01 Typical High $912.01 | Professional | None | $724.44 | $912.01 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $691.83 Typical High $954.99 | Facility | None | $588.84 | $691.83 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $724.44 | Professional | None | $645.65 | $691.83 | $724.44 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $10,232.93 | Facility | None | $501.19 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,258.93 | Professional | None | $524.81 | $630.96 | $1,258.93 |
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 $371.54 Median $489.78 Typical High $954.99 | Professional | None | $371.54 | $489.78 | $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 $275.42 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $416.87 |
Where Virginia sits
The same service costs 4.5 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 $7,632MT $1,703
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.