How much rates vary
Facilitymedian $2,291 · 10th to 90th $501 to $7,244Professionalmedian $513 · 10th to 90th $427 to $631
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 $549.54 Median $5,495.41 Typical High $14,125.38 | Facility | None | $549.54 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | None | $501.19 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $562.34 | Professional | None | $436.52 | $512.86 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $323.59 Typical High $354.81 | Professional | 62 · Two surgeons | $275.42 | $323.59 | $354.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $83.18 Typical High $91.20 | Professional | 80 · Assistant surgeon | $70.79 | $83.18 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $72.44 Typical High $79.43 | Professional | AS · PA/NP assist | $61.66 | $72.44 | $79.43 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $645.65 | Professional | None | $501.19 | $562.34 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,495.41 | Facility | None | $501.19 | $1,174.90 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $707.95 | Professional | None | $467.74 | $512.86 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $645.65 | Professional | None | $436.52 | $501.19 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $758.58 | Facility | None | $501.19 | $501.19 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $588.84 Typical High $602.56 | Professional | None | $269.15 | $588.84 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,737.80 Typical High $5,623.41 | Facility | None | $501.19 | $1,737.80 | $5,623.41 |
Sentara Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,122.02 | Professional | None | $457.09 | $537.03 | $1,122.02 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $758.58 | Professional | None | $371.54 | $436.52 | $758.58 |
4 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 $371.54 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $380.19 |
Where Virginia sits
The same service costs 11.7 times more in New York than in North Carolina. 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
$513
NY $3,802NC $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.