How much rates vary
Facilitymedian $6,166 · 10th to 90th $794 to $15,849Professionalmedian $676 · 10th to 90th $550 to $1,202
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 $724.44 Median $7,762.47 Typical High $15,488.17 | Facility | None | $724.44 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $7,079.46 | Professional | None | $676.08 | $724.44 | $7,079.46 |
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 $537.03 Median $645.65 Typical High $812.83 | Professional | None | $537.03 | $645.65 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $407.38 Typical High $512.86 | Professional | 62 · Two surgeons | $338.84 | $407.38 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $7,244.36 | Professional | None | $562.34 | $616.60 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,235.94 Typical High $6,165.95 | Facility | None | $1,348.96 | $3,235.94 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,023.29 | Professional | None | $549.54 | $776.25 | $1,023.29 |
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 $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | None | $870.96 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $851.14 Typical High $1,096.48 | Facility | None | $676.08 | $851.14 | $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 $588.84 Median $2,238.72 Typical High $10,715.19 | Facility | None | $588.84 | $2,238.72 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $10,232.93 | Professional | None | $602.56 | $831.76 | $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 $524.81 Median $851.14 Typical High $1,288.25 | Professional | None | $524.81 | $851.14 | $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 $363.08 | Professional | 52 · Reduced service | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $512.86 |
Where Virginia sits
The same service costs 5.8 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 $10,507MT $1,825
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.