How much rates vary
Facilitymedian $5,495 · 10th to 90th $813 to $15,488Professionalmedian $776 · 10th to 90th $646 to $1,122
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 $776.25 Median $5,495.41 Typical High $14,125.38 | Facility | None | $776.25 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | None | $741.31 | $776.25 | $776.25 |
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 $660.69 Median $794.33 Typical High $954.99 | Professional | None | $660.69 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,202.26 Typical High $1,445.44 | Professional | 50 · Both sides | $1,000.00 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $134.90 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,000.00 | Professional | None | $758.58 | $831.76 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $7,079.46 | Facility | None | $512.86 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,148.15 | Professional | None | $676.08 | $724.44 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | None | $630.96 | $758.58 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $954.99 Typical High $1,288.25 | Facility | None | $776.25 | $954.99 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,230.27 | Professional | None | $891.25 | $954.99 | $1,230.27 |
Sentara Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $10,715.19 | Facility | None | $691.83 | $2,137.96 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,659.59 | Professional | None | $645.65 | $891.25 | $1,659.59 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,348.96 | Professional | None | $489.78 | $676.08 | $1,348.96 |
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 $371.54 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $371.54 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $549.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $549.54 |
Where Virginia sits
The same service costs 8.7 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
$794
AK $2,884TX $331
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.