How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,023 to $15,488Professionalmedian $1,023 · 10th to 90th $813 to $1,413
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 $1,023.29 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,023.29 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,412.54 | Professional | None | $954.99 | $1,023.29 | $1,412.54 |
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 $870.96 Median $1,047.13 Typical High $1,258.93 | Professional | None | $870.96 | $1,047.13 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,548.82 Typical High $1,862.09 | Professional | 50 · Both sides | $1,288.25 | $1,548.82 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $199.53 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $144.54 Typical High $173.78 | Professional | AS · PA/NP assist | $120.23 | $144.54 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,348.96 | Professional | None | $912.01 | $1,023.29 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,230.27 | Professional | None | $831.76 | $1,000.00 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,698.24 | Facility | None | $1,023.29 | $1,174.90 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,148.15 | $1,778.28 |
Sentara Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $10,232.93 | Facility | None | $794.33 | $2,454.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $2,187.76 | Professional | None | $870.96 | $1,096.48 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,659.59 | Professional | None | $645.65 | $812.83 | $1,659.59 |
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 $478.63 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $724.44 |
Where Virginia sits
The same service costs 17.4 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· 37th of 51
$1,023
AK $3,715TX $214
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.