How much rates vary
Facilitymedian $2,344 · 10th to 90th $603 to $9,333Professionalmedian $1,230 · 10th to 90th $1,000 to $1,950
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 $1,318.26 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,318.26 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $4,365.16 | Professional | None | $1,230.27 | $1,318.26 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $17,378.01 | Facility | None | $8,912.51 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,479.11 | Professional | None | $977.24 | $1,174.90 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,238.72 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $190.55 Typical High $239.88 | Professional | 80 · Assistant surgeon | $158.49 | $190.55 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $208.93 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,122.02 | $1,412.54 |
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 $1,000.00 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,412.54 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,380.38 | Professional | None | $933.25 | $1,122.02 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,230.27 | $1,548.82 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $5,495.41 | Facility | None | $933.25 | $1,737.80 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $4,897.79 | Professional | None | $1,122.02 | $1,479.11 | $4,897.79 |
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 $977.24 Median $1,621.81 Typical High $2,398.83 | Professional | None | $977.24 | $1,621.81 | $2,398.83 |
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 $616.60 Median $616.60 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $263.03 | Professional | 53 · Discontinued | $245.47 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $933.25 |
Where Virginia sits
The same service costs 7.5 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 $13,030MD $1,737
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.