How much rates vary
Facilitymedian $4,365 · 10th to 90th $692 to $10,965Professionalmedian $661 · 10th to 90th $562 to $832
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 $724.44 Median $5,623.41 Typical High $10,964.78 | Facility | None | $724.44 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $724.44 | Professional | None | $691.83 | $707.95 | $724.44 |
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 $575.44 Median $691.83 Typical High $812.83 | Professional | None | $575.44 | $691.83 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,023.29 Typical High $1,230.27 | Professional | 50 · Both sides | $870.96 | $1,023.29 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $436.52 Typical High $512.86 | Professional | 62 · Two surgeons | $363.08 | $436.52 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $131.83 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $114.82 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $114.82 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $758.58 | Professional | None | $575.44 | $645.65 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,311.31 | Facility | None | $645.65 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $891.25 | Professional | None | $549.54 | $645.65 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $977.24 | Professional | None | $562.34 | $660.69 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | None | $724.44 | $912.01 | $912.01 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $758.58 Typical High $1,122.02 | Facility | None | $691.83 | $758.58 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $831.76 | Professional | None | $676.08 | $707.95 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $10,232.93 | Facility | None | $512.86 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,023.29 | Professional | None | $602.56 | $676.08 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $1,000.00 | Professional | None | $457.09 | $588.84 | $1,000.00 |
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 $346.74 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $524.81 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $512.86 |
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
$676
AK $2,512TX $427
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.