How much rates vary
Facilitymedian $2,188 · 10th to 90th $525 to $8,318Professionalmedian $912 · 10th to 90th $741 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 $977.24 Median $7,762.47 Typical High $15,848.93 | Facility | None | $977.24 | $7,762.47 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,318.26 | Professional | None | $870.96 | $933.25 | $1,318.26 |
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 $724.44 Median $870.96 Typical High $1,096.48 | Professional | None | $724.44 | $870.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $549.54 Typical High $676.08 | Professional | 62 · Two surgeons | $457.09 | $549.54 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $173.78 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $151.36 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,071.52 | Professional | None | $776.25 | $870.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,348.96 | Professional | None | $741.31 | $1,000.00 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | None | $741.31 | $891.25 | $1,096.48 |
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 $870.96 Median $1,096.48 Typical High $1,445.44 | Facility | None | $870.96 | $1,096.48 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $1,548.82 Typical High $7,413.10 | Facility | None | $741.31 | $1,548.82 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $3,981.07 | Professional | None | $776.25 | $1,071.52 | $3,981.07 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,659.59 | Professional | None | $691.83 | $1,122.02 | $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 $436.52 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $691.83 |
Where Virginia sits
The same service costs 4.6 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· 41st of 51
$933
AK $3,162TX $692
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.