How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,023 to $13,490Professionalmedian $1,023 · 10th to 90th $813 to $1,622
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 $1,122.02 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,122.02 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $3,235.94 | Professional | None | $758.58 | $1,000.00 | $3,235.94 |
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 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 $117.49 Median $141.25 Typical High $181.97 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $8,709.64 | Professional | None | $870.96 | $977.24 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $5,888.44 | Facility | None | $1,348.96 | $3,090.30 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,548.82 | Professional | None | $831.76 | $1,023.29 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,148.15 | Professional | None | $776.25 | $933.25 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,202.26 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $851.14 Median $1,174.90 Typical High $7,413.10 | Professional | None | $851.14 | $1,174.90 | $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 $741.31 Median $1,202.26 Typical High $1,737.80 | Professional | None | $741.31 | $1,202.26 | $1,737.80 |
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 $380.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $562.34 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $112.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $524.81 | $707.95 | $707.95 |
Where Virginia sits
The same service costs 4.2 times more in Colorado 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
CO $11,551MT $2,762
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.