How much rates vary
Facilitymedian $3,631 · 10th to 90th $631 to $9,550Professionalmedian $631 · 10th to 90th $513 to $891
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 $630.96 Median $5,370.32 Typical High $14,125.38 | Facility | None | $630.96 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $870.96 | Professional | None | $602.56 | $630.96 | $870.96 |
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 $549.54 Median $645.65 Typical High $776.25 | Professional | None | $549.54 | $645.65 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $977.24 Typical High $1,174.90 | Professional | 50 · Both sides | $812.83 | $977.24 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $104.71 Typical High $125.89 | Professional | 80 · Assistant surgeon | $87.10 | $104.71 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $91.20 Typical High $109.65 | Professional | AS · PA/NP assist | $75.86 | $91.20 | $109.65 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $831.76 | Professional | None | $562.34 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $891.25 | Professional | None | $537.03 | $588.84 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $794.33 | Professional | None | $524.81 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | None | $724.44 | $912.01 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $724.44 Typical High $1,047.13 | Facility | None | $630.96 | $724.44 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $676.08 | Professional | None | $436.52 | $524.81 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $8,709.64 | Facility | None | $512.86 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $1,348.96 | Professional | None | $549.54 | $660.69 | $1,348.96 |
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 $398.11 Median $524.81 Typical High $1,023.29 | Professional | None | $398.11 | $524.81 | $1,023.29 |
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 $302.00 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $426.58 | $446.68 | $446.68 |
Where Virginia sits
The same service costs 8.9 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
$631
AK $2,344TX $263
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.