How much rates vary
Facilitymedian $4,365 · 10th to 90th $676 to $10,965Professionalmedian $646 · 10th to 90th $537 to $794
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 $691.83 Median $5,623.41 Typical High $10,964.78 | Facility | None | $691.83 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | None | $660.69 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $794.33 | Professional | None | $562.34 | $676.08 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $416.87 Typical High $501.19 | Professional | 62 · Two surgeons | $354.81 | $416.87 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $741.31 | Professional | None | $562.34 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,311.31 | Facility | None | $645.65 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $870.96 | Professional | None | $537.03 | $630.96 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $954.99 | Professional | None | $549.54 | $630.96 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | None | $707.95 | $891.25 | $891.25 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $741.31 Typical High $1,096.48 | Facility | None | $660.69 | $741.31 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $741.31 | Professional | None | $660.69 | $724.44 | $741.31 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $1,819.70 Typical High $10,232.93 | Facility | None | $489.78 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $977.24 | Professional | None | $562.34 | $645.65 | $977.24 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $977.24 | Professional | None | $436.52 | $562.34 | $977.24 |
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 $331.13 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $489.78 |
Where Virginia sits
The same service costs 4.0 times more in Oklahoma 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
OK $7,771MT $1,932
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.