How much rates vary
Facilitymedian $5,129 · 10th to 90th $741 to $13,183Professionalmedian $708 · 10th to 90th $562 to $1,122
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 $5,623.41 Typical High $11,481.54 | Facility | None | $870.96 | $5,623.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,000.00 | Professional | None | $645.65 | $870.96 | $1,000.00 |
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 $562.34 Median $676.08 Typical High $812.83 | Professional | None | $562.34 | $676.08 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $109.65 Typical High $131.83 | Professional | 80 · Assistant surgeon | $91.20 | $109.65 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | AS · PA/NP assist | $79.43 | $95.50 | $114.82 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $5,754.40 | Facility | None | $724.44 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,202.26 | Professional | None | $588.84 | $794.33 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,174.90 | Professional | None | $776.25 | $933.25 | $1,174.90 |
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 $758.58 Median $1,000.00 Typical High $1,659.59 | Facility | None | $758.58 | $1,000.00 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,023.29 | Professional | None | $676.08 | $870.96 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $10,232.93 | Facility | None | $562.34 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,949.84 | Professional | None | $588.84 | $933.25 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,348.96 | Professional | None | $467.74 | $724.44 | $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 $323.59 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $323.59 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $128.82 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $575.44 Typical High $758.58 | Professional | 54 · Surgery only | $489.78 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $537.03 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $457.09 | $537.03 | $707.95 |
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· 40th of 51
$741
AK $3,020TX $490
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.