How much rates vary
Facilitymedian $5,370 · 10th to 90th $646 to $15,849Professionalmedian $603 · 10th to 90th $490 to $871
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 $741.31 Median $5,370.32 Typical High $14,125.38 | Facility | None | $741.31 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $891.25 | Professional | None | $575.44 | $602.56 | $891.25 |
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 $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 $100.00 Typical High $120.23 | Professional | 80 · Assistant surgeon | $83.18 | $100.00 | $120.23 |
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 $616.60 Typical High $794.33 | Professional | None | $549.54 | $616.60 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $7,079.46 | Facility | None | $524.81 | $3,019.95 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $870.96 | Professional | None | $512.86 | $562.34 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $758.58 | Professional | None | $501.19 | $602.56 | $758.58 |
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 $602.56 Median $707.95 Typical High $1,000.00 | Facility | None | $602.56 | $707.95 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $2,290.87 | Professional | None | $660.69 | $851.14 | $2,290.87 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $2,041.74 Typical High $10,715.19 | Facility | None | $512.86 | $2,041.74 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,288.25 | Professional | None | $537.03 | $660.69 | $1,288.25 |
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 $380.19 Median $489.78 Typical High $977.24 | Professional | None | $380.19 | $489.78 | $977.24 |
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 $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $288.40 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $426.58 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $426.58 |
Where Virginia sits
The same service costs 7.9 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 $13,941MT $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.