How much rates vary
Facilitymedian $4,266 · 10th to 90th $794 to $11,220Professionalmedian $794 · 10th to 90th $631 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 $794.33 Median $6,165.95 Typical High $11,481.54 | Facility | None | $794.33 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,096.48 | Professional | None | $741.31 | $794.33 | $1,096.48 |
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 $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,445.44 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $512.86 Typical High $616.60 | Professional | 62 · Two surgeons | $426.58 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $134.90 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,047.13 | Professional | None | $707.95 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,737.80 Typical High $3,467.37 | Facility | None | $724.44 | $1,737.80 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $1,122.02 | Professional | None | $660.69 | $724.44 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $977.24 | Professional | None | $645.65 | $776.25 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | None | $954.99 | $1,174.90 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $912.01 Typical High $1,318.26 | Facility | None | $794.33 | $912.01 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,862.09 | Professional | None | $851.14 | $1,071.52 | $1,862.09 |
Sentara Setting Facility Modifier None Typical Low $660.69 Median $1,905.46 Typical High $10,232.93 | Facility | None | $660.69 | $1,905.46 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,698.24 | Professional | None | $707.95 | $851.14 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,288.25 | Professional | None | $501.19 | $660.69 | $1,288.25 |
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 $371.54 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $562.34 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $549.54 |
Where Virginia sits
The same service costs 8.7 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· 36th of 51
$794
AK $2,951TX $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.