How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,349 to $21,380Professionalmedian $1,380 · 10th to 90th $1,122 to $1,698
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 $2,511.89 Median $7,585.78 Typical High $16,595.87 | Facility | None | $2,511.89 | $7,585.78 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,047.13 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $263.03 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $234.42 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,380.38 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,897.79 Typical High $9,772.37 | Facility | None | $512.86 | $4,897.79 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,318.26 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,288.25 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,290.87 | Facility | None | $1,412.54 | $1,584.89 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,513.56 | Professional | None | $954.99 | $1,174.90 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $18,620.87 | Facility | None | $1,000.00 | $3,090.30 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,348.96 | $2,089.30 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,041.74 | Professional | None | $912.01 | $1,174.90 | $2,041.74 |
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 $707.95 Median $707.95 Typical High $724.44 | Professional | 52 · Reduced service | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | 53 · Discontinued | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,023.29 |
Where Virginia sits
The same service costs 4.8 times more in Colorado than in Kentucky. 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 $16,795KY $3,466
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.