How much rates vary
Facilitymedian $3,981 · 10th to 90th $813 to $11,220Professionalmedian $891 · 10th to 90th $741 to $1,413
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 $891.25 Median $4,073.80 Typical High $10,000.00 | Facility | None | $891.25 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $2,570.40 | Professional | None | $831.76 | $891.25 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,122.02 | Professional | None | $741.31 | $870.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $141.25 Typical High $177.83 | Professional | 80 · Assistant surgeon | $117.49 | $141.25 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $158.49 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $5,495.41 | Professional | None | $758.58 | $851.14 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $2,454.71 Typical High $5,128.61 | Facility | None | $346.74 | $2,454.71 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,348.96 | Professional | None | $776.25 | $870.96 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | None | $691.83 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | None | $912.01 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,445.44 | Facility | None | $891.25 | $1,148.15 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $10,232.93 | Facility | None | $645.65 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $6,025.60 | Professional | None | $645.65 | $1,023.29 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,584.89 | Professional | None | $645.65 | $1,000.00 | $1,584.89 |
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 $416.87 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $616.60 |
Where Virginia sits
The same service costs 5.0 times more in Oklahoma than in Hawaii. 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 $9,757HI $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.