How much rates vary
Facilitymedian $4,677 · 10th to 90th $631 to $11,220Professionalmedian $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 $588.84 Median $630.96 Typical High $870.96 | Professional | None | $588.84 | $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 $537.03 Median $645.65 Typical High $776.25 | Professional | None | $537.03 | $645.65 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $954.99 Typical High $1,148.15 | Professional | 50 · Both sides | $812.83 | $954.99 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $407.38 Typical High $489.78 | Professional | 62 · Two surgeons | $338.84 | $407.38 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $102.33 Typical High $123.03 | Professional | 80 · Assistant surgeon | $85.11 | $102.33 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $89.13 Typical High $107.15 | Professional | AS · PA/NP assist | $75.86 | $89.13 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $831.76 | Professional | None | $575.44 | $630.96 | $831.76 |
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 $537.03 Median $575.44 Typical High $891.25 | Professional | None | $537.03 | $575.44 | $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 $776.25 Median $954.99 Typical High $954.99 | Professional | None | $776.25 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $724.44 Typical High $1,023.29 | Facility | None | $630.96 | $724.44 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $812.83 | Professional | None | $691.83 | $758.58 | $812.83 |
Sentara Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $10,232.93 | Facility | None | $549.54 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,348.96 | Professional | None | $562.34 | $660.69 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $1,023.29 | Professional | None | $389.05 | $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 $295.12 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $446.68 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $436.52 |
Where Virginia sits
The same service costs 7.6 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· 37th of 51
$631
AK $2,344TX $309
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.