How much rates vary
Facilitymedian $5,370 · 10th to 90th $813 to $15,488Professionalmedian $813 · 10th to 90th $646 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 $812.83 Median $5,370.32 Typical High $14,125.38 | Facility | None | $812.83 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,096.48 | Professional | None | $758.58 | $812.83 | $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 $1,230.27 Typical High $1,479.11 | Professional | 50 · Both sides | $1,023.29 | $1,230.27 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,047.13 | Professional | None | $724.44 | $812.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $7,079.46 | Facility | None | $524.81 | $3,019.95 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,122.02 | Professional | None | $676.08 | $741.31 | $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 $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | None | $977.24 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $933.25 Typical High $1,318.26 | Facility | None | $812.83 | $933.25 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,479.11 | Professional | None | $870.96 | $1,000.00 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $2,454.71 Typical High $10,715.19 | Facility | None | $676.08 | $2,454.71 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,698.24 | Professional | None | $676.08 | $851.14 | $1,698.24 |
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 $645.65 Typical High $1,288.25 | Professional | None | $501.19 | $645.65 | $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 $380.19 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $562.34 | $602.56 | $602.56 |
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 $75.86 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $562.34 |
Where Virginia sits
The same service costs 7.8 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
$813
AK $2,951TX $380
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.