How much rates vary
Facilitymedian $3,467 · 10th to 90th $676 to $10,000Professionalmedian $676 · 10th to 90th $562 to $1,072
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 $676.08 Median $5,623.41 Typical High $10,964.78 | Facility | None | $676.08 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $4,466.84 | Professional | None | $630.96 | $676.08 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $851.14 | Professional | None | $562.34 | $660.69 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $416.87 Typical High $537.03 | Professional | 62 · Two surgeons | $354.81 | $416.87 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $107.15 Typical High $134.90 | Professional | 80 · Assistant surgeon | $89.13 | $107.15 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $93.33 Typical High $120.23 | Professional | AS · PA/NP assist | $77.62 | $93.33 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $3,162.28 | Professional | None | $575.44 | $645.65 | $3,162.28 |
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 $588.84 Median $676.08 Typical High $1,023.29 | Professional | None | $588.84 | $676.08 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $776.25 | Professional | None | $524.81 | $630.96 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $933.25 | Professional | None | $741.31 | $933.25 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $1,096.48 | Facility | None | $676.08 | $870.96 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Sentara Setting Facility Modifier None Typical Low $537.03 Median $1,737.80 Typical High $8,709.64 | Facility | None | $537.03 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $4,570.88 | Professional | None | $562.34 | $794.33 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,202.26 | Professional | None | $489.78 | $758.58 | $1,202.26 |
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 $316.23 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $478.63 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $467.74 |
Where Virginia sits
The same service costs 5.4 times more in Alaska 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· 43rd of 51
$708
AK $2,399UT $447
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.