How much rates vary
Facilitymedian $3,090 · 10th to 90th $575 to $9,550Professionalmedian $575 · 10th to 90th $468 to $912
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 $575.44 Median $4,073.80 Typical High $10,000.00 | Facility | None | $575.44 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $2,238.72 | Professional | None | $562.34 | $575.44 | $2,238.72 |
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 $467.74 Median $562.34 Typical High $724.44 | Professional | None | $467.74 | $562.34 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $831.76 Typical High $1,071.52 | Professional | 50 · Both sides | $707.95 | $831.76 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $354.81 Typical High $446.68 | Professional | 62 · Two surgeons | $295.12 | $354.81 | $446.68 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $89.13 Typical High $114.82 | Professional | 80 · Assistant surgeon | $74.13 | $89.13 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $100.00 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $100.00 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $2,818.38 | Professional | None | $489.78 | $537.03 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,659.59 Typical High $3,235.94 | Facility | None | $346.74 | $1,659.59 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $870.96 | Professional | None | $489.78 | $588.84 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $660.69 | Professional | None | $446.68 | $524.81 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $562.34 Median $741.31 Typical High $933.25 | Facility | None | $562.34 | $741.31 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $1,737.80 Typical High $8,709.64 | Facility | None | $478.63 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $4,073.80 | Professional | None | $501.19 | $676.08 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $416.87 Median $676.08 Typical High $1,000.00 | Professional | None | $416.87 | $676.08 | $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 $288.40 | Professional | 52 · Reduced service | $263.03 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $398.11 |
Where Virginia sits
The same service costs 5.5 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· 47th of 51
$589
AK $2,042UT $372
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.