How much rates vary
Facilitymedian $3,890 · 10th to 90th $871 to $11,220Professionalmedian $813 · 10th to 90th $646 to $1,148
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 $870.96 Median $7,762.47 Typical High $15,488.17 | Facility | None | $870.96 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,174.90 | Professional | None | $794.33 | $870.96 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | None | $707.95 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $141.25 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,096.48 | Professional | None | $741.31 | $831.76 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $5,754.40 | Facility | None | $1,000.00 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,148.15 | Professional | None | $616.60 | $758.58 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,023.29 | Professional | None | $676.08 | $812.83 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,122.02 | Professional | None | $851.14 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $933.25 Typical High $1,445.44 | Facility | None | $870.96 | $933.25 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | None | $794.33 | $794.33 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,778.28 Typical High $8,709.64 | Facility | None | $616.60 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,819.70 | Professional | None | $588.84 | $851.14 | $1,819.70 |
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 $512.86 Median $691.83 Typical High $1,380.38 | Professional | None | $512.86 | $691.83 | $1,380.38 |
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 $398.11 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $616.60 |
Where Virginia sits
The same service costs 17.4 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· 35th of 51
$832
AK $3,020TX $174
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.