How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,000 to $11,220Professionalmedian $1,072 · 10th to 90th $871 to $1,738
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 $1,071.52 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,071.52 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $3,801.89 | Professional | None | $1,071.52 | $1,071.52 | $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 $870.96 Median $1,047.13 Typical High $1,348.96 | Professional | None | $870.96 | $1,047.13 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $660.69 Typical High $851.14 | Professional | 62 · Two surgeons | $549.54 | $660.69 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $141.25 | $169.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $147.91 Typical High $186.21 | Professional | AS · PA/NP assist | $123.03 | $147.91 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $8,511.38 | Professional | None | $912.01 | $1,023.29 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $9,549.93 | Facility | None | $524.81 | $3,019.95 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,621.81 | Professional | None | $912.01 | $1,096.48 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,230.27 | Professional | None | $831.76 | $977.24 | $1,230.27 |
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 $1,071.52 Median $1,445.44 Typical High $1,737.80 | Facility | None | $1,071.52 | $1,445.44 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $10,232.93 | Facility | None | $912.01 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $6,025.60 | Professional | None | $954.99 | $1,288.25 | $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 $776.25 Median $1,288.25 Typical High $1,905.46 | Professional | None | $776.25 | $1,288.25 | $1,905.46 |
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 $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $758.58 |
Where Virginia sits
The same service costs 6.3 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· 42nd of 51
$1,096
OK $4,169UT $661
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.