How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,288 to $16,218Professionalmedian $851 · 10th to 90th $692 to $1,096
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 $1,096.48 Median $7,762.47 Typical High $15,848.93 | Facility | None | $1,096.48 | $7,762.47 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,096.48 | $1,318.26 |
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 $691.83 Median $812.83 Typical High $977.24 | Professional | None | $691.83 | $812.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,230.27 Typical High $1,445.44 | Professional | 50 · Both sides | $1,023.29 | $1,230.27 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $602.56 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $154.88 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $134.90 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $5,623.41 Median $7,585.78 Typical High $10,000.00 | Professional | None | $5,623.41 | $7,585.78 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,659.59 | Facility | None | $1,096.48 | $1,096.48 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,318.26 | $2,187.76 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $7,413.10 Typical High $14,791.08 | Facility | None | $1,737.80 | $7,413.10 | $14,791.08 |
Sentara Setting Professional Modifier None Typical Low $4,570.88 Median $10,232.93 Typical High $16,218.10 | Professional | None | $4,570.88 | $10,232.93 | $16,218.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $758.58 |
Where Virginia sits
The same service costs 104.7 times more in Wisconsin than in Montana. 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· 50th of 51
$871
WI $8,318MT $79.43
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.