How much rates vary
Facilitymedian $5,754 · 10th to 90th $955 to $14,791Professionalmedian $933 · 10th to 90th $759 to $1,318
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 $954.99 Median $7,762.47 Typical High $15,488.17 | Facility | None | $954.99 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,288.25 | Professional | None | $870.96 | $954.99 | $1,288.25 |
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 $794.33 Median $954.99 Typical High $1,148.15 | Professional | None | $794.33 | $954.99 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $724.44 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $181.97 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | AS · PA/NP assist | $109.65 | $131.83 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,230.27 | Professional | None | $831.76 | $933.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $7,244.36 | Facility | None | $1,000.00 | $3,630.78 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,318.26 | Professional | None | $794.33 | $851.14 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | None | $741.31 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,318.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,548.82 | Facility | None | $954.99 | $1,047.13 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,096.48 | $1,096.48 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $10,232.93 | Facility | None | $741.31 | $2,290.87 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $2,041.74 | Professional | None | $794.33 | $977.24 | $2,041.74 |
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 $588.84 Median $758.58 Typical High $1,548.82 | Professional | None | $588.84 | $758.58 | $1,548.82 |
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 $436.52 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $660.69 |
Where Virginia sits
The same service costs 22.4 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
$955
AK $3,388TX $151
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.