How much rates vary
Facilitymedian $5,623 · 10th to 90th $692 to $15,488Professionalmedian $692 · 10th to 90th $550 to $1,175
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 $5,495.41 Typical High $14,125.38 | Facility | None | $741.31 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,445.44 | Professional | None | $676.08 | $741.31 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $831.76 | Professional | None | $549.54 | $645.65 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $977.24 Typical High $1,230.27 | Professional | 50 · Both sides | $812.83 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $407.38 Typical High $524.81 | Professional | 62 · Two surgeons | $346.74 | $407.38 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $104.71 Typical High $131.83 | Professional | 80 · Assistant surgeon | $87.10 | $104.71 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $91.20 Typical High $114.82 | Professional | AS · PA/NP assist | $75.86 | $91.20 | $114.82 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $6,918.31 | Professional | None | $588.84 | $660.69 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $6,025.60 | Facility | None | $512.86 | $3,090.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,047.13 | Professional | None | $549.54 | $741.31 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $758.58 | Professional | None | $512.86 | $616.60 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,096.48 | Professional | None | $851.14 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $1,096.48 | Facility | None | $676.08 | $870.96 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Sentara Setting Facility Modifier None Typical Low $575.44 Median $2,238.72 Typical High $10,715.19 | Facility | None | $575.44 | $2,238.72 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $10,232.93 | Professional | None | $602.56 | $812.83 | $10,232.93 |
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 $537.03 Median $870.96 Typical High $1,288.25 | Professional | None | $537.03 | $870.96 | $1,288.25 |
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 $338.84 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $338.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $512.86 |
Where Virginia sits
The same service costs 5.6 times more in Wisconsin 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
WI $10,313MT $1,845
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.