How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,047 to $15,849Professionalmedian $1,122 · 10th to 90th $912 to $1,585
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 $1,122.02 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,122.02 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,122.02 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | None | $954.99 | $1,122.02 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,698.24 Typical High $2,041.74 | Professional | 50 · Both sides | $1,412.54 | $1,698.24 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $158.49 Typical High $190.55 | Professional | AS · PA/NP assist | $131.83 | $158.49 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,122.02 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,801.89 Typical High $12,882.50 | Facility | None | $724.44 | $3,801.89 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $933.25 | $1,023.29 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,348.96 | Professional | None | $891.25 | $1,071.52 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,862.09 | Facility | None | $1,122.02 | $1,318.26 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,412.54 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $12,882.50 | Facility | None | $912.01 | $2,454.71 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,398.83 | Professional | None | $933.25 | $1,202.26 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $26,915.35 | Facility | None | $2,570.40 | $10,000.00 | $26,915.35 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,819.70 | Professional | None | $707.95 | $912.01 | $1,819.70 |
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 $524.81 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $794.33 |
Where Virginia sits
The same service costs 8.5 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
$1,122
AK $4,074TX $479
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.