How much rates vary
Facilitymedian $1,950 · 10th to 90th $617 to $6,026Professionalmedian $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 $912.01 Median $4,786.30 Typical High $10,000.00 | Facility | None | $912.01 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | None | $870.96 | $870.96 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | None | $707.95 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $162.18 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $141.25 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $912.01 | Professional | None | $724.44 | $794.33 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $831.76 Typical High $2,187.76 | Facility | None | $478.63 | $831.76 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,122.02 | Professional | None | $691.83 | $812.83 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,148.15 | Professional | None | $724.44 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $977.24 Typical High $1,412.54 | Facility | None | $870.96 | $977.24 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $933.25 | Professional | None | $575.44 | $630.96 | $933.25 |
Sentara Setting Facility Modifier None Typical Low $562.34 Median $1,230.27 Typical High $3,715.35 | Facility | None | $562.34 | $1,230.27 | $3,715.35 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,258.93 | Professional | None | $549.54 | $851.14 | $1,258.93 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,288.25 | Professional | None | $588.84 | $724.44 | $1,288.25 |
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 $436.52 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | 54 · Surgery only | $645.65 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $645.65 |
Where Virginia sits
The same service costs 4.7 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· 32nd of 51
$832
AK $2,399TX $513
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.