How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,122 to $11,220Professionalmedian $1,122 · 10th to 90th $912 to $1,622
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 $5,370.32 Typical High $14,125.38 | Facility | None | $1,122.02 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,348.96 | Professional | None | $1,047.13 | $1,122.02 | $1,348.96 |
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 $954.99 Median $1,148.15 Typical High $1,380.38 | Professional | None | $954.99 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,698.24 Typical High $2,089.30 | Professional | 50 · Both sides | $1,445.44 | $1,698.24 | $2,089.30 |
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 $134.90 Median $158.49 Typical High $190.55 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,122.02 | $1,479.11 |
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 $977.24 Median $1,023.29 Typical High $1,659.59 | Professional | None | $977.24 | $1,023.29 | $1,659.59 |
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 $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,862.09 | Facility | None | $1,122.02 | $1,412.54 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,621.81 | $1,905.46 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $10,232.93 | Facility | None | $933.25 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,000.00 | $1,288.25 | $2,398.83 |
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 $707.95 Median $977.24 Typical High $1,949.84 | Professional | None | $707.95 | $977.24 | $1,949.84 |
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 $213.80 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $794.33 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $165.96 |
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 $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $776.25 |
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· 36th of 51
$1,148
AK $4,169TX $501
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.