How much rates vary
Facilitymedian $3,162 · 10th to 90th $661 to $10,000Professionalmedian $661 · 10th to 90th $513 to $1,023
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 $724.44 Median $4,168.69 Typical High $11,481.54 | Facility | None | $724.44 | $4,168.69 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $3,235.94 | Professional | None | $501.19 | $602.56 | $3,235.94 |
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 $549.54 Median $660.69 Typical High $851.14 | Professional | None | $549.54 | $660.69 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $416.87 Typical High $537.03 | Professional | 62 · Two surgeons | $346.74 | $416.87 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $107.15 Typical High $134.90 | Professional | 80 · Assistant surgeon | $89.13 | $107.15 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $93.33 Typical High $120.23 | Professional | AS · PA/NP assist | $77.62 | $93.33 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $3,890.45 | Professional | None | $588.84 | $645.65 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,467.37 | Facility | None | $724.44 | $1,819.70 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $954.99 | Professional | None | $524.81 | $602.56 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $776.25 | Professional | None | $524.81 | $630.96 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $602.56 Median $660.69 Typical High $1,000.00 | Facility | None | $602.56 | $660.69 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $8,709.64 | Facility | None | $478.63 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $5,128.61 | Professional | None | $537.03 | $691.83 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,071.52 | Professional | None | $426.58 | $676.08 | $1,071.52 |
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 $251.19 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $251.19 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $50.12 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $354.81 | $426.58 | $426.58 |
Where Virginia sits
The same service costs 3.6 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 $6,446MT $1,806
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.