How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,023 to $11,220Professionalmedian $1,122 · 10th to 90th $891 to $1,862
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 $1,174.90 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,174.90 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,148.15 | $1,584.89 |
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 $891.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $891.25 | $1,047.13 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $831.76 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $141.25 | $169.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $147.91 Typical High $186.21 | Professional | AS · PA/NP assist | $123.03 | $147.91 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $3,715.35 | Professional | None | $954.99 | $1,047.13 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $3,162.28 | Facility | None | $512.86 | $1,698.24 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $891.25 | $1,258.93 | $1,737.80 |
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 $1,445.44 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,862.09 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,778.28 | Facility | None | $1,071.52 | $1,445.44 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $10,232.93 | Facility | None | $912.01 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $8,511.38 | Professional | None | $954.99 | $1,380.38 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,137.96 | Professional | None | $870.96 | $1,479.11 | $2,137.96 |
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 $537.03 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $831.76 |
Where Virginia sits
The same service costs 4.6 times more in Wisconsin 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· 42nd of 51
$1,202
WI $3,981TX $871
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.