How much rates vary
Facilitymedian $3,236 · 10th to 90th $380 to $10,000Professionalmedian $331 · 10th to 90th $275 to $537
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 $331.13 Median $5,623.41 Typical High $10,964.78 | Facility | None | $331.13 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $4,365.16 | Professional | None | $316.23 | $331.13 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | None | $275.42 | $331.13 | $416.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | 62 · Two surgeons | $173.78 | $208.93 | $263.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $52.48 Typical High $67.61 | Professional | 80 · Assistant surgeon | $43.65 | $52.48 | $67.61 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $45.71 Typical High $57.54 | Professional | AS · PA/NP assist | $38.02 | $45.71 | $57.54 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $3,162.28 | Professional | None | $288.40 | $323.59 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,258.93 Typical High $2,754.23 | Facility | None | $645.65 | $1,258.93 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $501.19 | Professional | None | $288.40 | $338.84 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $389.05 | Professional | None | $263.03 | $316.23 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | None | $371.54 | $467.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $537.03 | Facility | None | $331.13 | $426.58 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $1,318.26 Typical High $8,709.64 | Facility | None | $269.15 | $1,318.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $4,570.88 | Professional | None | $288.40 | $389.05 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $588.84 | Professional | None | $239.88 | $389.05 | $588.84 |
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 $158.49 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $63.10 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $229.09 |
Where Virginia sits
The same service costs 6.6 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 $6,126MT $925
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.