How much rates vary
Facilitymedian $5,623 · 10th to 90th $851 to $13,490Professionalmedian $813 · 10th to 90th $676 to $1,023
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 $891.25 Median $6,165.95 Typical High $11,481.54 | Facility | None | $891.25 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $891.25 | Professional | None | $812.83 | $851.14 | $891.25 |
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 $691.83 Median $812.83 Typical High $977.24 | Professional | None | $691.83 | $812.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $933.25 | Professional | None | $707.95 | $794.33 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $5,754.40 | Facility | None | $724.44 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,096.48 | Professional | None | $676.08 | $794.33 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,230.27 | Professional | None | $676.08 | $776.25 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $1,230.27 Typical High $1,230.27 | Professional | None | $724.44 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,348.96 | Facility | None | $812.83 | $954.99 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,148.15 | Professional | None | $691.83 | $724.44 | $1,148.15 |
Sentara Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $10,232.93 | Facility | None | $602.56 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,230.27 | Professional | None | $588.84 | $831.76 | $1,230.27 |
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 $575.44 Median $707.95 Typical High $1,258.93 | Professional | None | $575.44 | $707.95 | $1,258.93 |
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 $407.38 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $407.38 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $162.18 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $630.96 |
Where Virginia sits
The same service costs 6.2 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· 33rd of 51
$813
AK $3,020TX $490
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.