How much rates vary
Facilitymedian $7,079 · 10th to 90th $933 to $25,119Professionalmedian $912 · 10th to 90th $724 to $1,259
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 $933.25 Median $7,079.46 Typical High $14,125.38 | Facility | None | $933.25 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,258.93 | Professional | None | $870.96 | $933.25 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $21,877.62 Median $28,183.83 Typical High $30,199.52 | Facility | None | $21,877.62 | $28,183.83 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | None | $776.25 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $1,698.24 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $588.84 Typical High $707.95 | Professional | 62 · Two surgeons | $489.78 | $588.84 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $177.83 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | AS · PA/NP assist | $109.65 | $131.83 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,202.26 | Professional | None | $831.76 | $912.01 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,801.89 Typical High $12,882.50 | Facility | None | $724.44 | $3,801.89 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,288.25 | Professional | None | $758.58 | $851.14 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,122.02 | Professional | None | $741.31 | $891.25 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,258.93 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,513.56 | Facility | None | $933.25 | $1,047.13 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,174.90 | Professional | None | $977.24 | $1,148.15 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $660.69 Median $2,238.72 Typical High $16,218.10 | Facility | None | $660.69 | $2,238.72 | $16,218.10 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,949.84 | Professional | None | $660.69 | $977.24 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $10,000.00 Typical High $25,118.86 | Facility | None | $1,995.26 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,479.11 | Professional | None | $562.34 | $741.31 | $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 $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $645.65 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $645.65 |
Where Virginia sits
The same service costs 16.2 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
$933
AK $3,388TX $209
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.