How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $13,490Professionalmedian $813 · 10th to 90th $676 to $1,288
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 $812.83 Median $5,370.32 Typical High $14,125.38 | Facility | None | $812.83 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $3,801.89 | Professional | None | $794.33 | $812.83 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,023.29 | Professional | None | $676.08 | $794.33 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $501.19 Typical High $645.65 | Professional | 62 · Two surgeons | $416.87 | $501.19 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $144.54 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $6,918.31 | Professional | None | $691.83 | $776.25 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,630.27 Typical High $5,128.61 | Facility | None | $524.81 | $2,630.27 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,230.27 | Professional | None | $691.83 | $812.83 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $933.25 | Professional | None | $630.96 | $741.31 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | None | $954.99 | $1,174.90 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,318.26 | Facility | None | $812.83 | $1,071.52 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $10,232.93 | Facility | None | $676.08 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $7,413.10 | Professional | None | $707.95 | $954.99 | $7,413.10 |
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 |
United Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,380.38 | Professional | None | $588.84 | $954.99 | $1,380.38 |
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 $380.19 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $616.60 | Professional | 54 · Surgery only | $562.34 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $575.44 |
Where Virginia sits
The same service costs 8.7 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· 41st of 51
$851
OK $4,365UT $501
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.