How much rates vary
Facilitymedian $2,138 · 10th to 90th $575 to $6,026Professionalmedian $692 · 10th to 90th $537 to $977
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 $707.95 Median $4,786.30 Typical High $10,000.00 | Facility | None | $707.95 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,023.29 | Professional | None | $660.69 | $707.95 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $870.96 | Professional | None | $602.56 | $724.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | 80 · Assistant surgeon | $95.50 | $114.82 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $100.00 Typical High $120.23 | Professional | AS · PA/NP assist | $83.18 | $100.00 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $831.76 | Professional | None | $645.65 | $707.95 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $2,187.76 | Facility | None | $478.63 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $977.24 | Professional | None | $549.54 | $645.65 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | None | $602.56 | $741.31 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $1,174.90 | Facility | None | $588.84 | $588.84 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,047.13 | Professional | None | $630.96 | $691.83 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $1,174.90 Typical High $3,630.78 | Facility | None | $426.58 | $1,174.90 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,513.56 | Professional | None | $416.87 | $691.83 | $1,513.56 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,148.15 | Professional | None | $398.11 | $562.34 | $1,148.15 |
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 $331.13 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $331.13 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $501.19 |
Where Virginia sits
The same service costs 7.4 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· 35th of 51
$708
AK $2,570TX $347
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.