How much rates vary
Facilitymedian $4,786 · 10th to 90th $692 to $13,490Professionalmedian $741 · 10th to 90th $603 to $1,122
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 $812.83 Median $4,786.30 Typical High $10,000.00 | Facility | None | $812.83 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $3,467.37 | Professional | None | $691.83 | $724.44 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $954.99 | Professional | None | $616.60 | $741.31 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $104.71 Typical High $131.83 | Professional | AS · PA/NP assist | $87.10 | $104.71 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $4,365.16 | Professional | None | $616.60 | $691.83 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,691.53 Typical High $5,754.40 | Facility | None | $478.63 | $2,691.53 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,071.52 | Professional | None | $630.96 | $707.95 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $851.14 | Professional | None | $575.44 | $691.83 | $851.14 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $977.24 | Professional | None | $794.33 | $977.24 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $794.33 Typical High $1,122.02 | Facility | None | $691.83 | $794.33 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Sentara Setting Facility Modifier None Typical Low $562.34 Median $2,137.96 Typical High $10,232.93 | Facility | None | $562.34 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $7,413.10 | Professional | None | $575.44 | $776.25 | $7,413.10 |
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 $501.19 Median $831.76 Typical High $1,230.27 | Professional | None | $501.19 | $831.76 | $1,230.27 |
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 $346.74 Median $346.74 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $562.34 |
Where Virginia sits
The same service costs 8.1 times more in Oklahoma than in Utah. 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· 40th of 51
$776
OK $3,548UT $437
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.