How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,445 to $15,849Professionalmedian $1,445 · 10th to 90th $1,175 to $2,042
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 $1,479.11 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,479.11 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,187.76 Typical High $2,630.27 | Professional | 50 · Both sides | $1,819.70 | $2,187.76 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $281.84 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,412.54 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $7,585.78 | Facility | None | $1,318.26 | $3,801.89 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,288.25 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,380.38 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,698.24 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,398.83 | Facility | None | $1,479.11 | $1,698.24 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,584.89 | $1,819.70 |
Sentara Setting Facility Modifier None Typical Low $1,047.13 Median $2,951.21 Typical High $12,589.25 | Facility | None | $1,047.13 | $2,951.21 | $12,589.25 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,621.81 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,630.27 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,344.23 | Professional | None | $870.96 | $1,202.26 | $2,344.23 |
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 $676.08 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $676.08 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,023.29 |
Where Virginia sits
The same service costs 4.7 times more in Colorado than in Kentucky. 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 $15,002KY $3,224
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.