How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,047 to $13,490Professionalmedian $1,096 · 10th to 90th $891 to $1,778
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 $5,370.32 Typical High $10,000.00 | Facility | None | $1,096.48 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $3,548.13 | Professional | None | $1,071.52 | $1,096.48 | $3,548.13 |
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 $891.25 Median $1,071.52 Typical High $1,380.38 | Professional | None | $891.25 | $1,071.52 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $676.08 Typical High $870.96 | Professional | 62 · Two surgeons | $562.34 | $676.08 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $218.78 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $151.36 Typical High $194.98 | Professional | AS · PA/NP assist | $125.89 | $151.36 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $5,495.41 | Professional | None | $933.25 | $1,047.13 | $5,495.41 |
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 $933.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $933.25 | $1,122.02 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | None | $851.14 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,621.81 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,778.28 | Facility | None | $1,096.48 | $1,445.44 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $10,232.93 | Facility | None | $912.01 | $2,454.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $7,413.10 | Professional | None | $977.24 | $1,288.25 | $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 $794.33 Median $1,288.25 Typical High $1,949.84 | Professional | None | $794.33 | $1,288.25 | $1,949.84 |
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 $512.86 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $512.86 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $776.25 |
Where Virginia sits
The same service costs 5.9 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· 44th of 51
$1,122
OK $4,074UT $692
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.