How much rates vary
Facilitymedian $5,754 · 10th to 90th $794 to $15,488Professionalmedian $794 · 10th to 90th $646 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 $794.33 Median $7,079.46 Typical High $14,125.38 | Facility | None | $794.33 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,071.52 | Professional | None | $724.44 | $794.33 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | None | $660.69 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,202.26 Typical High $1,445.44 | Professional | 50 · Both sides | $1,000.00 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $151.36 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $134.90 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $912.01 | Professional | None | $724.44 | $812.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $7,079.46 | Facility | None | $512.86 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,202.26 | Professional | None | $676.08 | $776.25 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | None | $630.96 | $758.58 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,318.26 | Facility | None | $794.33 | $1,122.02 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,122.02 | $2,398.83 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $2,137.96 Typical High $10,715.19 | Facility | None | $741.31 | $2,137.96 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,737.80 | Professional | None | $741.31 | $977.24 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,348.96 | Professional | None | $501.19 | $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 $363.08 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $562.34 |
Where Virginia sits
The same service costs 7.2 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· 39th of 51
$813
AK $2,884TX $398
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.