How much rates vary
Facilitymedian $3,890 · 10th to 90th $759 to $10,233Professionalmedian $741 · 10th to 90th $589 to $1,096
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 $741.31 Median $5,623.41 Typical High $10,964.78 | Facility | None | $741.31 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $1,047.13 | Professional | None | $724.44 | $741.31 | $1,047.13 |
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 $630.96 Median $758.58 Typical High $912.01 | Professional | None | $630.96 | $758.58 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $120.23 Typical High $144.54 | Professional | 80 · Assistant surgeon | $100.00 | $120.23 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $125.89 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $977.24 | Professional | None | $676.08 | $758.58 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $5,754.40 | Facility | None | $645.65 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,096.48 | Professional | None | $660.69 | $691.83 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $912.01 | Professional | None | $616.60 | $741.31 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | None | $676.08 | $1,258.93 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $933.25 Typical High $1,202.26 | Facility | None | $741.31 | $933.25 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,047.13 | Professional | None | $660.69 | $891.25 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $549.54 Median $1,778.28 Typical High $9,332.54 | Facility | None | $549.54 | $1,778.28 | $9,332.54 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $1,621.81 | Professional | None | $501.19 | $851.14 | $1,621.81 |
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 $436.52 Median $645.65 Typical High $1,318.26 | Professional | None | $436.52 | $645.65 | $1,318.26 |
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 $354.81 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $354.81 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $512.86 |
Where Virginia sits
The same service costs 8.1 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· 38th of 51
$759
AK $2,754TX $339
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.