How much rates vary
Facilitymedian $3,715 · 10th to 90th $794 to $10,965Professionalmedian $813 · 10th to 90th $661 to $1,259
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 $5,623.41 Typical High $10,964.78 | Facility | None | $812.83 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $4,365.16 | Professional | None | $794.33 | $794.33 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,000.00 | Professional | None | $660.69 | $776.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $125.89 Typical High $162.18 | Professional | 80 · Assistant surgeon | $104.71 | $125.89 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $109.65 Typical High $141.25 | Professional | AS · PA/NP assist | $91.20 | $109.65 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $2,511.89 | Professional | None | $676.08 | $758.58 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,778.28 Typical High $3,311.31 | Facility | None | $645.65 | $1,778.28 | $3,311.31 |
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 $616.60 Median $724.44 Typical High $912.01 | Professional | None | $616.60 | $724.44 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | None | $912.01 | $1,122.02 | $1,122.02 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,318.26 | Facility | None | $794.33 | $1,047.13 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $645.65 Median $1,905.46 Typical High $10,232.93 | Facility | None | $645.65 | $1,905.46 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $6,025.60 | Professional | None | $691.83 | $933.25 | $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 $575.44 Median $933.25 Typical High $1,412.54 | Professional | None | $575.44 | $933.25 | $1,412.54 |
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 $371.54 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $562.34 |
Where Virginia sits
The same service costs 5.8 times more in Alaska 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
$832
AK $2,818UT $490
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.