How much rates vary
Facilitymedian $2,818 · 10th to 90th $468 to $9,550Professionalmedian $468 · 10th to 90th $380 to $646
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 $467.74 Median $4,073.80 Typical High $10,000.00 | Facility | None | $467.74 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $645.65 | Professional | None | $446.68 | $467.74 | $645.65 |
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 $407.38 Median $478.63 Typical High $575.44 | Professional | None | $407.38 | $478.63 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $724.44 Typical High $870.96 | Professional | 50 · Both sides | $602.56 | $724.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $302.00 Typical High $363.08 | Professional | 62 · Two surgeons | $257.04 | $302.00 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $77.62 Typical High $93.33 | Professional | 80 · Assistant surgeon | $64.57 | $77.62 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $67.61 Typical High $81.28 | Professional | AS · PA/NP assist | $56.23 | $67.61 | $81.28 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $630.96 | Professional | None | $426.58 | $478.63 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,621.81 Typical High $3,090.30 | Facility | None | $346.74 | $1,621.81 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $660.69 | Professional | None | $389.05 | $436.52 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $602.56 | Professional | None | $398.11 | $478.63 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | None | $524.81 | $645.65 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $524.81 Typical High $776.25 | Facility | None | $467.74 | $524.81 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $741.31 | Professional | None | $489.78 | $562.34 | $741.31 |
Sentara Setting Facility Modifier None Typical Low $363.08 Median $1,548.82 Typical High $8,709.64 | Facility | None | $363.08 | $1,548.82 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $1,023.29 | Professional | None | $389.05 | $478.63 | $1,023.29 |
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 $295.12 Median $380.19 Typical High $758.58 | Professional | None | $295.12 | $380.19 | $758.58 |
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 $223.87 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $331.13 |
Where Virginia sits
The same service costs 8.3 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
$479
AK $1,738TX $209
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.