How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $9,550Professionalmedian $776 · 10th to 90th $617 to $1,072
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 $5,370.32 Typical High $14,125.38 | Facility | None | $776.25 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,071.52 | Professional | None | $741.31 | $776.25 | $1,071.52 |
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 $1,174.90 Typical High $1,412.54 | Professional | 50 · Both sides | $1,000.00 | $1,174.90 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $125.89 Typical High $151.36 | Professional | 80 · Assistant surgeon | $104.71 | $125.89 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $131.83 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,023.29 | Professional | None | $707.95 | $776.25 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,187.76 Typical High $4,073.80 | Facility | None | $524.81 | $2,187.76 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,071.52 | Professional | None | $645.65 | $707.95 | $1,071.52 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | None | $851.14 | $1,047.13 | $1,047.13 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,288.25 | Facility | None | $776.25 | $812.83 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,000.00 | Professional | None | $776.25 | $933.25 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $8,709.64 | Facility | None | $602.56 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,659.59 | Professional | None | $676.08 | $794.33 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,258.93 | Professional | None | $467.74 | $616.60 | $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 $363.08 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $147.91 | $154.88 | $154.88 |
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 8.5 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· 36th of 51
$776
AK $2,884TX $339
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.