How much rates vary
Facilitymedian $4,365 · 10th to 90th $603 to $10,965Professionalmedian $562 · 10th to 90th $457 to $891
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 $562.34 Median $5,623.41 Typical High $10,964.78 | Facility | None | $562.34 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $3,981.07 | Professional | None | $562.34 | $562.34 | $3,981.07 |
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 $457.09 Median $549.54 Typical High $707.95 | Professional | None | $457.09 | $549.54 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $831.76 Typical High $1,047.13 | Professional | 50 · Both sides | $691.83 | $831.76 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $89.13 Typical High $112.20 | Professional | 80 · Assistant surgeon | $74.13 | $89.13 | $112.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $77.62 Typical High $97.72 | Professional | AS · PA/NP assist | $64.57 | $77.62 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $3,890.45 | Professional | None | $478.63 | $537.03 | $3,890.45 |
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 $478.63 Median $562.34 Typical High $851.14 | Professional | None | $478.63 | $562.34 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $645.65 | Professional | None | $436.52 | $524.81 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $724.44 Typical High $912.01 | Facility | None | $562.34 | $724.44 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $446.68 Median $1,819.70 Typical High $10,232.93 | Facility | None | $446.68 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $6,025.60 | Professional | None | $489.78 | $645.65 | $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 $407.38 Median $630.96 Typical High $1,000.00 | Professional | None | $407.38 | $630.96 | $1,000.00 |
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 $263.03 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $389.05 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $398.11 |
Where Virginia sits
The same service costs 10.0 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· 47th of 51
$575
OK $3,631UT $363
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.