How much rates vary
Facilitymedian $4,266 · 10th to 90th $891 to $10,965Professionalmedian $912 · 10th to 90th $741 to $1,318
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 $912.01 Median $5,370.32 Typical High $14,125.38 | Facility | None | $912.01 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,230.27 | Professional | None | $870.96 | $870.96 | $1,230.27 |
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 $794.33 Median $954.99 Typical High $1,148.15 | Professional | None | $794.33 | $954.99 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $724.44 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $181.97 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,230.27 | Professional | None | $851.14 | $933.25 | $1,230.27 |
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 $758.58 Median $851.14 Typical High $1,318.26 | Professional | None | $758.58 | $851.14 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,202.26 | Professional | None | $794.33 | $954.99 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,380.38 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,445.44 | Facility | None | $870.96 | $1,023.29 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,778.28 | Professional | None | $954.99 | $954.99 | $1,778.28 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $10,232.93 | Facility | None | $812.83 | $2,187.76 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,995.26 | Professional | None | $812.83 | $977.24 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,479.11 | Professional | None | $562.34 | $776.25 | $1,479.11 |
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 $436.52 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $630.96 |
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· 38th of 51
$933
AK $3,467TX $468
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.