How much rates vary
Facilitymedian $4,169 · 10th to 90th $933 to $10,965Professionalmedian $933 · 10th to 90th $759 to $1,479
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 $5,370.32 Typical High $14,125.38 | Facility | None | $933.25 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $3,801.89 | Professional | None | $912.01 | $933.25 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,174.90 | Professional | None | $758.58 | $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 $144.54 Typical High $186.21 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,148.15 | Professional | None | $794.33 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $3,235.94 | Facility | None | $524.81 | $1,778.28 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,412.54 | Professional | None | $794.33 | $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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,380.38 | $1,380.38 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,513.56 | Facility | None | $933.25 | $1,230.27 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Sentara Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $10,232.93 | Facility | None | $794.33 | $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 $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,659.59 | Professional | None | $676.08 | $1,096.48 | $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 $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $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 $645.65 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $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 $602.56 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $660.69 |
Where Virginia sits
The same service costs 6.6 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· 43rd of 51
$955
OK $3,802UT $575
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.