How much rates vary
Facilitymedian $3,715 · 10th to 90th $741 to $10,233Professionalmedian $813 · 10th to 90th $631 to $1,148
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 $912.01 Median $5,370.32 Typical High $10,964.78 | Facility | None | $912.01 | $5,370.32 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,023.29 | Professional | None | $741.31 | $851.14 | $1,023.29 |
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 $645.65 Median $831.76 Typical High $1,096.48 | Professional | None | $645.65 | $831.76 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $131.83 Typical High $177.83 | Professional | 80 · Assistant surgeon | $102.33 | $131.83 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $154.88 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $831.76 | Professional | None | $630.96 | $707.95 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $5,754.40 | Facility | None | $645.65 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,122.02 | Professional | None | $660.69 | $831.76 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,380.38 | Professional | None | $831.76 | $954.99 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,318.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $912.01 Typical High $1,513.56 | Facility | None | $741.31 | $912.01 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,023.29 | Professional | None | $501.19 | $794.33 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $8,709.64 | Facility | None | $630.96 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,412.54 | Professional | None | $707.95 | $912.01 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,258.93 | Professional | None | $537.03 | $741.31 | $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 $371.54 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $371.54 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $208.93 | Professional | 53 · Discontinued | $147.91 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $776.25 | Professional | 54 · Surgery only | $562.34 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $724.44 |
Where Virginia sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 35th of 51
$832
AK $2,754NJ $631
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.