How much rates vary
Facilitymedian $9,333 · 10th to 90th $891 to $27,542Professionalmedian $891 · 10th to 90th $741 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 $1,096.48 Median $5,495.41 Typical High $14,791.08 | Facility | None | $1,096.48 | $5,495.41 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $3,467.37 | Professional | None | $851.14 | $891.25 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $14,791.08 Typical High $21,379.62 | Facility | None | $7,413.10 | $14,791.08 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,122.02 | Professional | None | $741.31 | $891.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $562.34 Typical High $707.95 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $141.25 Typical High $181.97 | Professional | 80 · Assistant surgeon | $117.49 | $141.25 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $158.49 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $6,918.31 | Professional | None | $776.25 | $851.14 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $3,019.95 Typical High $33,113.11 | Facility | None | $478.63 | $3,019.95 | $33,113.11 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,380.38 | Professional | None | $776.25 | $912.01 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | None | $691.83 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,479.11 | Facility | None | $891.25 | $1,174.90 | $1,479.11 |
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 $724.44 Median $2,454.71 Typical High $18,620.87 | Facility | None | $724.44 | $2,454.71 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $10,232.93 | Professional | None | $741.31 | $1,071.52 | $10,232.93 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $12,882.50 Typical High $38,904.51 | Facility | None | $4,570.88 | $12,882.50 | $38,904.51 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,621.81 | Professional | None | $660.69 | $1,047.13 | $1,621.81 |
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 $416.87 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $630.96 |
Where Virginia sits
The same service costs 6.8 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· 40th of 51
$933
AK $3,715TX $550
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.