How much rates vary
Facilitymedian $3,981 · 10th to 90th $832 to $11,220Professionalmedian $813 · 10th to 90th $661 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 $831.76 Median $7,079.46 Typical High $15,488.17 | Facility | None | $831.76 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,148.15 | Professional | None | $776.25 | $831.76 | $1,148.15 |
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 $691.83 Median $831.76 Typical High $1,000.00 | Professional | None | $691.83 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $162.18 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $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 $812.83 Typical High $1,071.52 | Professional | None | $741.31 | $812.83 | $1,071.52 |
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 $676.08 Median $758.58 Typical High $1,148.15 | Professional | None | $676.08 | $758.58 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $977.24 | Professional | None | $645.65 | $776.25 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | None | $954.99 | $1,174.90 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $933.25 Typical High $1,348.96 | Facility | None | $831.76 | $933.25 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $912.01 | Professional | None | $812.83 | $851.14 | $912.01 |
Sentara Setting Facility Modifier None Typical Low $660.69 Median $1,778.28 Typical High $9,332.54 | Facility | None | $660.69 | $1,778.28 | $9,332.54 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,778.28 | Professional | None | $660.69 | $851.14 | $1,778.28 |
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 $524.81 Median $660.69 Typical High $1,348.96 | Professional | None | $524.81 | $660.69 | $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 $389.05 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $588.84 |
Where Virginia sits
The same service costs 8.5 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· 35th of 51
$832
AK $3,020TX $355
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.