How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,023 to $14,791Professionalmedian $1,047 · 10th to 90th $851 to $1,660
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 $1,288.25 Median $7,079.46 Typical High $15,488.17 | Facility | None | $1,288.25 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $3,981.07 | Professional | None | $977.24 | $1,047.13 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,589.25 | Facility | None | $8,511.38 | $11,220.18 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,288.25 | Professional | None | $851.14 | $1,023.29 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,513.56 Typical High $1,949.84 | Professional | 50 · Both sides | $1,288.25 | $1,513.56 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $645.65 Typical High $812.83 | Professional | 62 · Two surgeons | $537.03 | $645.65 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $162.18 Typical High $208.93 | Professional | 80 · Assistant surgeon | $134.90 | $162.18 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $181.97 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $8,511.38 | Professional | None | $933.25 | $1,023.29 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,801.89 Typical High $9,772.37 | Facility | None | $724.44 | $3,801.89 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,584.89 | Professional | None | $891.25 | $1,047.13 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,174.90 | Professional | None | $794.33 | $933.25 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,698.24 | Facility | None | $1,047.13 | $1,380.38 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Sentara Setting Facility Modifier None Typical Low $831.76 Median $2,454.71 Typical High $10,232.93 | Facility | None | $831.76 | $2,454.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $7,413.10 | Professional | None | $870.96 | $1,202.26 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,862.09 | Professional | None | $758.58 | $1,230.27 | $1,862.09 |
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 $489.78 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $489.78 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $724.44 |
Where Virginia sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.