How much rates vary
Facilitymedian $3,890 · 10th to 90th $708 to $11,220Professionalmedian $832 · 10th to 90th $646 to $1,349
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 $954.99 Median $5,495.41 Typical High $14,125.38 | Facility | None | $954.99 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,230.27 | Professional | None | $794.33 | $891.25 | $1,230.27 |
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 $691.83 Median $831.76 Typical High $1,047.13 | Professional | None | $691.83 | $831.76 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $169.82 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $144.54 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $3,715.35 | Professional | None | $741.31 | $831.76 | $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 $602.56 Median $776.25 Typical High $1,288.25 | Professional | None | $602.56 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,318.26 | Facility | None | $741.31 | $741.31 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $467.74 Median $1,949.84 Typical High $10,232.93 | Facility | None | $467.74 | $1,949.84 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $954.99 Typical High $8,511.38 | Professional | None | $501.19 | $954.99 | $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 $537.03 Median $851.14 Typical High $1,479.11 | Professional | None | $537.03 | $851.14 | $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 $398.11 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Where Virginia sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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· 46th of 51
$871
OK $4,169KY $617
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.