How much rates vary
Facilitymedian $2,291 · 10th to 90th $550 to $10,000Professionalmedian $1,380 · 10th to 90th $1,122 to $2,089
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 $1,412.54 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,412.54 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,380.38 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,589.25 | Facility | None | $8,511.38 | $11,220.18 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $275.42 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $239.88 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,288.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,380.38 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,238.72 | Facility | None | $1,380.38 | $1,659.59 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Sentara Setting Facility Modifier None Typical Low $977.24 Median $1,778.28 Typical High $5,623.41 | Facility | None | $977.24 | $1,778.28 | $5,623.41 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,548.82 | $2,951.21 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,621.81 | $2,454.71 |
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 $660.69 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $1,000.00 |
Where Virginia sits
The same service costs 6.3 times more in Colorado than in Maryland. 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 $11,778MD $1,881
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.