How much rates vary
Facilitymedian $9,772 · 10th to 90th $575 to $46,774Professionalmedian $525 · 10th to 90th $427 to $977
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 $2,454.71 Median $8,511.38 Typical High $16,595.87 | Facility | None | $2,454.71 | $8,511.38 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $7,079.46 | Professional | None | $512.86 | $575.44 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $40,738.03 Median $47,863.01 Typical High $53,703.18 | Facility | None | $40,738.03 | $47,863.01 | $53,703.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $630.96 | Professional | None | $416.87 | $501.19 | $630.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $316.23 Typical High $389.05 | Professional | 62 · Two surgeons | $263.03 | $316.23 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $7,244.36 | Professional | None | $426.58 | $478.63 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $7,244.36 Typical High $14,125.38 | Facility | None | $512.86 | $7,244.36 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $776.25 | Professional | None | $426.58 | $575.44 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $562.34 | Professional | None | $380.19 | $457.09 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | None | $588.84 | $724.44 | $724.44 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $660.69 Typical High $831.76 | Facility | None | $512.86 | $660.69 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $1,737.80 Typical High $22,908.68 | Facility | None | $426.58 | $1,737.80 | $22,908.68 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $11,481.54 | Professional | None | $436.52 | $630.96 | $11,481.54 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $14,454.40 Typical High $56,234.13 | Facility | None | $4,570.88 | $14,454.40 | $56,234.13 |
United Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $977.24 | Professional | None | $407.38 | $616.60 | $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 $257.04 Median $257.04 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $398.11 |
Where Virginia sits
The same service costs 16.2 times more in Oklahoma 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
OK $21,968MT $1,353
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.