How much rates vary
Facilitymedian $1,148 · 10th to 90th $275 to $4,898Professionalmedian $309 · 10th to 90th $245 to $513
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 $354.81 Median $2,041.74 Typical High $9,332.54 | Facility | None | $354.81 | $2,041.74 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $575.44 | Professional | None | $275.42 | $398.11 | $575.44 |
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 $245.47 Median $295.12 Typical High $354.81 | Professional | None | $245.47 | $295.12 | $354.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $46.77 Typical High $56.23 | Professional | 80 · Assistant surgeon | $39.81 | $46.77 | $56.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $41.69 Typical High $50.12 | Professional | AS · PA/NP assist | $34.67 | $41.69 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $338.84 | Professional | None | $257.04 | $281.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $323.59 Typical High $776.25 | Facility | None | $50.12 | $323.59 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $537.03 | Professional | None | $257.04 | $363.08 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $588.84 | Professional | None | $389.05 | $457.09 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $645.65 | Facility | None | $288.40 | $398.11 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $645.65 | Professional | None | $398.11 | $436.52 | $645.65 |
Sentara Setting Facility Modifier None Typical Low $229.09 Median $630.96 Typical High $5,011.87 | Facility | None | $229.09 | $630.96 | $5,011.87 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $891.25 | Professional | None | $331.13 | $407.38 | $891.25 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $3,630.78 | Facility | None | $323.59 | $1,445.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $588.84 | Professional | None | $199.53 | $309.03 | $588.84 |
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 $138.04 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $138.04 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $54.95 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $204.17 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $281.84 |
Where Virginia sits
The same service costs 4.5 times more in Alaska than in Texas. 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.
Virginia· 41st of 51
$324
AK $1,072TX $240
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.