How much rates vary
Facilitymedian $5,370 · 10th to 90th $794 to $15,136Professionalmedian $776 · 10th to 90th $617 to $1,349
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 $933.25 Median $4,365.16 Typical High $10,964.78 | Facility | None | $933.25 | $4,365.16 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $4,365.16 | Professional | None | $758.58 | $812.83 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $8,709.64 Typical High $11,481.54 | Facility | None | $6,309.57 | $8,709.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $933.25 | Professional | None | $616.60 | $724.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $575.44 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $147.91 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $128.82 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $7,943.28 | Professional | None | $630.96 | $707.95 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $6,025.60 | Facility | None | $645.65 | $3,090.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,202.26 | Professional | None | $630.96 | $851.14 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $851.14 | Professional | None | $575.44 | $691.83 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | None | $977.24 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $1,230.27 | Facility | None | $758.58 | $933.25 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Sentara Setting Facility Modifier None Typical Low $660.69 Median $2,454.71 Typical High $10,715.19 | Facility | None | $660.69 | $2,454.71 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $10,232.93 | Professional | None | $660.69 | $933.25 | $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 $588.84 Median $977.24 Typical High $1,412.54 | Professional | None | $588.84 | $977.24 | $1,412.54 |
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 $380.19 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $575.44 |
Where Virginia sits
The same service costs 5.3 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 $10,556MT $2,002
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.