How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,047 to $13,183Professionalmedian $933 · 10th to 90th $776 to $1,445
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 $933.25 Median $5,888.44 Typical High $14,125.38 | Facility | None | $933.25 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $3,981.07 | Professional | None | $870.96 | $933.25 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $13,803.84 | Facility | None | $3,090.30 | $7,413.10 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,174.90 | Professional | None | $776.25 | $912.01 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $575.44 Typical High $741.31 | Professional | 62 · Two surgeons | $478.63 | $575.44 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $186.21 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $165.96 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,230.27 | Professional | None | $851.14 | $933.25 | $1,230.27 |
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 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,412.54 | Professional | None | $812.83 | $954.99 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,071.52 | Professional | None | $724.44 | $851.14 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,513.56 | Facility | None | $933.25 | $1,202.26 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $2,238.72 Typical High $10,232.93 | Facility | None | $741.31 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $6,025.60 | Professional | None | $812.83 | $1,096.48 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,659.59 | Professional | None | $676.08 | $1,047.13 | $1,659.59 |
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 $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $660.69 |
Where Virginia sits
The same service costs 6.2 times more in Oklahoma 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· 38th of 51
$1,000
OK $3,631UT $589
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.