How much rates vary
Facilitymedian $4,467 · 10th to 90th $891 to $13,490Professionalmedian $851 · 10th to 90th $708 to $1,230
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 $851.14 Median $5,370.32 Typical High $14,125.38 | Facility | None | $851.14 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,174.90 | Professional | None | $812.83 | $851.14 | $1,174.90 |
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 $724.44 Median $870.96 Typical High $1,047.13 | Professional | None | $724.44 | $870.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $1,584.89 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $165.96 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $954.99 | Professional | None | $776.25 | $851.14 | $954.99 |
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 $741.31 Median $776.25 Typical High $1,288.25 | Professional | None | $741.31 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,047.13 | Professional | None | $691.83 | $831.76 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,621.81 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,412.54 | Facility | None | $851.14 | $1,071.52 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,174.90 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $10,232.93 | Facility | None | $794.33 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,819.70 | Professional | None | $758.58 | $1,000.00 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,548.82 | Professional | None | $537.03 | $741.31 | $1,548.82 |
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 $398.11 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $602.56 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $562.34 | $602.56 | $602.56 |
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· 37th of 51
$871
AK $3,162TX $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.