How much rates vary
Facilitymedian $1,738 · 10th to 90th $550 to $5,888Professionalmedian $617 · 10th to 90th $513 to $759
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 $676.08 Median $5,495.41 Typical High $14,125.38 | Facility | None | $676.08 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $676.08 | Professional | None | $630.96 | $645.65 | $676.08 |
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 $537.03 Median $630.96 Typical High $758.58 | Professional | None | $537.03 | $630.96 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $398.11 Typical High $478.63 | Professional | 62 · Two surgeons | $338.84 | $398.11 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $100.00 Typical High $120.23 | Professional | 80 · Assistant surgeon | $85.11 | $100.00 | $120.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $87.10 Typical High $104.71 | Professional | AS · PA/NP assist | $74.13 | $87.10 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $724.44 | Professional | None | $562.34 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $741.31 Typical High $1,659.59 | Facility | None | $346.74 | $741.31 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $831.76 | Professional | None | $524.81 | $602.56 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $891.25 | Professional | None | $524.81 | $616.60 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | None | $724.44 | $912.01 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $707.95 Typical High $1,023.29 | Facility | None | $630.96 | $707.95 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,230.27 | Professional | None | $660.69 | $812.83 | $1,230.27 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $3,630.78 | Facility | None | $512.86 | $1,071.52 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $912.01 | Professional | None | $524.81 | $588.84 | $912.01 |
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 $416.87 Median $537.03 Typical High $912.01 | Professional | None | $416.87 | $537.03 | $912.01 |
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 $316.23 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 54 · Surgery only | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $467.74 |
Where Virginia sits
The same service costs 5.5 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· 37th of 51
$631
AK $2,188TX $398
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.