How much rates vary
Facilitymedian $4,571 · 10th to 90th $759 to $15,488Professionalmedian $776 · 10th to 90th $617 to $1,096
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 $758.58 Median $5,495.41 Typical High $14,125.38 | Facility | None | $758.58 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,479.11 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,479.11 |
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 $95.50 Median $112.20 Typical High $134.90 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,023.29 | Professional | None | $776.25 | $870.96 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $3,162.28 | Facility | None | $512.86 | $1,737.80 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,096.48 | Professional | None | $602.56 | $724.44 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,000.00 | Professional | None | $660.69 | $794.33 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | None | $891.25 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $758.58 Median $870.96 Typical High $1,258.93 | Facility | None | $758.58 | $870.96 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,230.27 | Professional | None | $812.83 | $977.24 | $1,230.27 |
Sentara Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $10,715.19 | Facility | None | $630.96 | $2,137.96 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,698.24 | Professional | None | $630.96 | $794.33 | $1,698.24 |
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 $630.96 Typical High $1,258.93 | Professional | None | $489.78 | $630.96 | $1,258.93 |
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 $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $537.03 |
Where Virginia sits
The same service costs 19.5 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· 40th of 51
$776
AK $2,951TX $151
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.