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 $537.03 Median $5,370.32 Typical High $14,791.08 | Facility | None | $537.03 | $5,370.32 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $630.96 | Professional | None | $436.52 | $457.09 | $630.96 |
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 $363.08 Median $426.58 Typical High $512.86 | Professional | None | $363.08 | $426.58 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $269.15 Typical High $323.59 | Professional | 62 · Two surgeons | $229.09 | $269.15 | $323.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $67.61 Typical High $81.28 | Professional | 80 · Assistant surgeon | $57.54 | $67.61 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $58.88 Typical High $72.44 | Professional | AS · PA/NP assist | $51.29 | $58.88 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | None | $380.19 | $416.87 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $575.44 | Professional | None | $363.08 | $407.38 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $630.96 | Professional | None | $346.74 | $398.11 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | None | $512.86 | $645.65 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $707.95 | Facility | None | $501.19 | $501.19 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | None | $457.09 | $467.74 | $524.81 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $741.31 Typical High $12,589.25 | Facility | None | $316.23 | $741.31 | $12,589.25 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $588.84 | Professional | None | $389.05 | $426.58 | $588.84 |
United Setting Facility Modifier None Typical Low $7,244.36 Median $11,748.98 Typical High $26,915.35 | Facility | None | $7,244.36 | $11,748.98 | $26,915.35 |
United Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $645.65 | Professional | None | $295.12 | $371.54 | $645.65 |
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 $331.13 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $316.23 |
Where Virginia sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 39th of 51
$417
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.