How much rates vary
Facilitymedian $5,129 · 10th to 90th $708 to $13,183Professionalmedian $724 · 10th to 90th $562 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 $851.14 Median $5,495.41 Typical High $10,964.78 | Facility | None | $851.14 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $870.96 | Professional | None | $676.08 | $851.14 | $870.96 |
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 $588.84 Median $707.95 Typical High $851.14 | Professional | None | $588.84 | $707.95 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $112.20 Typical High $134.90 | Professional | 80 · Assistant surgeon | $93.33 | $112.20 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $117.49 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $117.49 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
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 $616.60 Median $758.58 Typical High $1,174.90 | Professional | None | $616.60 | $758.58 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,122.02 | Professional | None | $741.31 | $891.25 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | None | $758.58 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $870.96 Typical High $1,412.54 | Facility | None | $707.95 | $870.96 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $891.25 | Professional | None | $602.56 | $676.08 | $891.25 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $10,232.93 | Facility | None | $512.86 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $1,905.46 | Professional | None | $537.03 | $891.25 | $1,905.46 |
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 $446.68 Median $676.08 Typical High $1,318.26 | Professional | None | $446.68 | $676.08 | $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 $338.84 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $134.90 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $67.61 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $602.56 |
Where Virginia sits
The same service costs 6.6 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
$741
AK $3,020TX $457
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.