How much rates vary
Facilitymedian $7,079 · 10th to 90th $871 to $15,849Professionalmedian $832 · 10th to 90th $708 to $1,047
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 $2,884.03 Median $8,317.64 Typical High $16,595.87 | Facility | None | $2,884.03 | $8,317.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $891.25 | Professional | None | $870.96 | $870.96 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,589.25 | Facility | None | $8,511.38 | $11,220.18 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,023.29 | Professional | None | $724.44 | $851.14 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $524.81 Typical High $645.65 | Professional | 62 · Two surgeons | $457.09 | $524.81 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $141.25 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $977.24 | Professional | None | $758.58 | $831.76 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $5,754.40 | Facility | None | $724.44 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,122.02 | Professional | None | $707.95 | $812.83 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,230.27 | Professional | None | $691.83 | $812.83 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,258.93 | $1,258.93 |
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 $870.96 Median $954.99 Typical High $1,318.26 | Professional | None | $870.96 | $954.99 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $691.83 Median $2,818.38 Typical High $10,715.19 | Facility | None | $691.83 | $2,818.38 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,288.25 | Professional | None | $707.95 | $831.76 | $1,288.25 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,258.93 | Professional | None | $562.34 | $724.44 | $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 $436.52 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $630.96 |
Where Virginia sits
The same service costs 25.1 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· 34th of 51
$832
AK $3,090TX $123
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.