How much rates vary
Facilitymedian $3,631 · 10th to 90th $692 to $10,233Professionalmedian $631 · 10th to 90th $501 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 $691.83 Median $7,079.46 Typical High $15,488.17 | Facility | None | $691.83 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $812.83 | Professional | None | $549.54 | $691.83 | $812.83 |
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 $501.19 Median $588.84 Typical High $724.44 | Professional | None | $501.19 | $588.84 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | 80 · Assistant surgeon | $79.43 | $95.50 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $83.18 Typical High $100.00 | Professional | AS · PA/NP assist | $69.18 | $83.18 | $100.00 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $776.25 | Professional | None | $524.81 | $588.84 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,238.72 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,047.13 | Professional | None | $524.81 | $645.65 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | None | $630.96 | $758.58 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $891.25 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,348.96 | Facility | None | $691.83 | $851.14 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $912.01 | Professional | None | $724.44 | $724.44 | $912.01 |
Sentara Setting Facility Modifier None Typical Low $588.84 Median $1,737.80 Typical High $8,709.64 | Facility | None | $588.84 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,659.59 | Professional | None | $645.65 | $851.14 | $1,659.59 |
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 $616.60 Typical High $1,230.27 | Professional | None | $426.58 | $616.60 | $1,230.27 |
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 $275.42 Median $346.74 Typical High $407.38 | Professional | 52 · Reduced service | $275.42 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $141.25 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $104.71 Typical High $123.03 | Professional | 55 · Aftercare only | $83.18 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $489.78 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $489.78 | $575.44 |
Where Virginia sits
The same service costs 6.2 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· 43rd of 51
$646
AK $2,570TX $417
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.