How much rates vary
Facilitymedian $5,623 · 10th to 90th $794 to $19,953Professionalmedian $851 · 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 $3,235.94 Median $8,511.38 Typical High $16,595.87 | Facility | None | $3,235.94 | $8,511.38 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $912.01 | Professional | None | $870.96 | $891.25 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $12,589.25 Typical High $23,442.29 | Facility | None | $5,248.07 | $12,589.25 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,023.29 | Professional | None | $724.44 | $870.96 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $549.54 Typical High $645.65 | Professional | 62 · Two surgeons | $457.09 | $549.54 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $165.96 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $144.54 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $977.24 | Professional | None | $758.58 | $851.14 | $977.24 |
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 $724.44 Median $812.83 Typical High $1,148.15 | Professional | None | $724.44 | $812.83 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,258.93 | Professional | None | $707.95 | $812.83 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,445.44 | Facility | None | $870.96 | $1,000.00 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $891.25 | $1,071.52 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $707.95 Median $1,737.80 Typical High $7,413.10 | Facility | None | $707.95 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,288.25 | Professional | None | $741.31 | $851.14 | $1,288.25 |
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 $575.44 Median $741.31 Typical High $1,258.93 | Professional | None | $575.44 | $741.31 | $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 $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 $660.69 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $134.90 |
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 $616.60 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $630.96 |
Where Virginia sits
The same service costs 5.9 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· 36th of 51
$851
AK $3,162TX $537
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.