How much rates vary
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 $851.14 Median $5,495.41 Typical High $15,488.17 | Facility | None | $851.14 | $5,495.41 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | None | $724.44 | $724.44 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $758.58 | Professional | None | $575.44 | $676.08 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $426.58 Typical High $478.63 | Professional | 62 · Two surgeons | $363.08 | $426.58 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $120.23 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $120.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $104.71 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $954.99 | Professional | None | $741.31 | $831.76 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $8,912.51 Typical High $19,054.61 | Facility | None | $1,318.26 | $8,912.51 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $933.25 | Professional | None | $630.96 | $707.95 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $741.31 | Professional | None | $501.19 | $575.44 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,288.25 | Facility | None | $851.14 | $851.14 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $794.33 | Professional | None | $363.08 | $398.11 | $794.33 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $2,754.23 Typical High $18,620.87 | Facility | None | $512.86 | $2,754.23 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,122.02 | Professional | None | $436.52 | $616.60 | $1,122.02 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $338.84 Median $660.69 Typical High $1,348.96 | Professional | None | $338.84 | $660.69 | $1,348.96 |
2 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 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $602.56 |
Where Virginia sits
The same service costs 8.3 times more in South Dakota than in Kentucky. 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· 38th of 51
$708
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.