How much rates vary
Facilitymedian $5,129 · 10th to 90th $912 to $12,589Professionalmedian $933 · 10th to 90th $759 to $1,349
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 $4,786.30 Typical High $9,332.54 | Facility | None | $1,122.02 | $4,786.30 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Professional | None | $912.01 | $912.01 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,174.90 | Professional | None | $812.83 | $977.24 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $616.60 Typical High $741.31 | Professional | 62 · Two surgeons | $512.86 | $616.60 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $186.21 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $165.96 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,258.93 | Professional | None | $870.96 | $954.99 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $9,772.37 | Facility | None | $524.81 | $3,019.95 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,348.96 | Professional | None | $776.25 | $870.96 | $1,348.96 |
Kaiser Permanente 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 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,479.11 | Facility | None | $912.01 | $1,047.13 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,445.44 | Professional | None | $977.24 | $977.24 | $1,445.44 |
Sentara Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $10,232.93 | Facility | None | $831.76 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $2,041.74 | Professional | None | $831.76 | $1,000.00 | $2,041.74 |
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 $575.44 Median $794.33 Typical High $1,513.56 | Professional | None | $575.44 | $794.33 | $1,513.56 |
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 $457.09 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $645.65 |
Where Virginia sits
The same service costs 7.6 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
$955
AK $3,548TX $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.