How much rates vary
Facilitymedian $3,467 · 10th to 90th $871 to $9,550Professionalmedian $871 · 10th to 90th $692 to $1,230
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 $1,000.00 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,000.00 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $2,089.30 | Professional | None | $676.08 | $1,000.00 | $2,089.30 |
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 $741.31 Median $870.96 Typical High $1,047.13 | Professional | None | $741.31 | $870.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $1,548.82 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $141.25 Typical High $165.96 | Professional | 80 · Assistant surgeon | $117.49 | $141.25 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | None | $741.31 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,479.11 Typical High $3,548.13 | Facility | None | $630.96 | $1,479.11 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,202.26 | Professional | None | $707.95 | $758.58 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $954.99 | Professional | None | $676.08 | $776.25 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,445.44 | Facility | None | $676.08 | $1,047.13 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Sentara Setting Facility Modifier None Typical Low $758.58 Median $1,778.28 Typical High $8,709.64 | Facility | None | $758.58 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $4,570.88 | Professional | None | $794.33 | $933.25 | $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 $602.56 Median $812.83 Typical High $1,348.96 | Professional | None | $602.56 | $812.83 | $1,348.96 |
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 $338.84 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $338.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $512.86 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $67.61 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $478.63 | $707.95 | $707.95 |
Where Virginia sits
The same service costs 3.7 times more in Oklahoma than in Mississippi. 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 $7,181MS $1,948
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.