How much rates vary
Facilitymedian $4,074 · 10th to 90th $479 to $10,965Professionalmedian $479 · 10th to 90th $389 to $832
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 $524.81 Median $4,786.30 Typical High $10,000.00 | Facility | None | $524.81 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $3,981.07 | Professional | None | $457.09 | $524.81 | $3,981.07 |
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 $389.05 Median $467.74 Typical High $588.84 | Professional | None | $389.05 | $467.74 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $74.13 Typical High $93.33 | Professional | 80 · Assistant surgeon | $61.66 | $74.13 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $64.57 Typical High $81.28 | Professional | AS · PA/NP assist | $54.95 | $64.57 | $81.28 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $6,918.31 | Professional | None | $407.38 | $457.09 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,630.27 Typical High $5,495.41 | Facility | None | $478.63 | $2,630.27 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $691.83 | Professional | None | $398.11 | $467.74 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $575.44 | Professional | None | $389.05 | $467.74 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | None | $501.19 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $489.78 Typical High $741.31 | Facility | None | $457.09 | $489.78 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $354.81 Median $1,737.80 Typical High $10,232.93 | Facility | None | $354.81 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $8,511.38 | Professional | None | $354.81 | $537.03 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $812.83 | Professional | None | $354.81 | $549.54 | $812.83 |
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 $229.09 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $371.54 |
Where Virginia sits
The same service costs 5.4 times more in Alaska than in New York. 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· 47th of 51
$513
AK $2,239NY $417
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.