How much rates vary
Facilitymedian $5,248 · 10th to 90th $589 to $13,490Professionalmedian $537 · 10th to 90th $457 to $692
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 $588.84 Median $5,370.32 Typical High $14,125.38 | Facility | None | $588.84 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $588.84 | Professional | None | $562.34 | $562.34 | $588.84 |
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 $467.74 Median $562.34 Typical High $660.69 | Professional | None | $467.74 | $562.34 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $87.10 Typical High $104.71 | Professional | 80 · Assistant surgeon | $74.13 | $87.10 | $104.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $75.86 Typical High $93.33 | Professional | AS · PA/NP assist | $66.07 | $75.86 | $93.33 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $616.60 | Professional | None | $467.74 | $524.81 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $5,754.40 | Facility | None | $524.81 | $2,691.53 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $741.31 | Professional | None | $467.74 | $524.81 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $831.76 | Professional | None | $426.58 | $489.78 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $794.33 | Professional | None | $630.96 | $794.33 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $676.08 Typical High $933.25 | Facility | None | $562.34 | $676.08 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,023.29 | Professional | None | $549.54 | $645.65 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $1,905.46 Typical High $10,232.93 | Facility | None | $478.63 | $1,905.46 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $851.14 | Professional | None | $478.63 | $575.44 | $851.14 |
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 $398.11 Median $478.63 Typical High $870.96 | Professional | None | $398.11 | $478.63 | $870.96 |
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 $281.84 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $416.87 |
Where Virginia sits
The same service costs 6.3 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· 35th of 51
$550
AK $2,042TX $324
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.