How much rates vary
Facilitymedian $6,761 · 10th to 90th $537 to $15,849Professionalmedian $490 · 10th to 90th $407 to $776
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 $489.78 Median $8,317.64 Typical High $15,488.17 | Facility | None | $489.78 | $8,317.64 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $4,365.16 | Professional | None | $478.63 | $489.78 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,589.25 | Facility | None | $8,511.38 | $11,220.18 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $616.60 | Professional | None | $407.38 | $478.63 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $724.44 Typical High $933.25 | Professional | 50 · Both sides | $602.56 | $724.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $302.00 Typical High $389.05 | Professional | 62 · Two surgeons | $257.04 | $302.00 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $77.62 Typical High $97.72 | Professional | 80 · Assistant surgeon | $64.57 | $77.62 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $67.61 Typical High $87.10 | Professional | AS · PA/NP assist | $56.23 | $67.61 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $6,165.95 | Professional | None | $416.87 | $467.74 | $6,165.95 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $5,888.44 | Facility | None | $1,348.96 | $3,090.30 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $741.31 | Professional | None | $426.58 | $489.78 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $575.44 | Professional | None | $389.05 | $457.09 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | None | $537.03 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $489.78 Median $616.60 Typical High $794.33 | Facility | None | $489.78 | $616.60 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Sentara Setting Facility Modifier None Typical Low $380.19 Median $1,737.80 Typical High $10,715.19 | Facility | None | $380.19 | $1,737.80 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $7,413.10 | Professional | None | $398.11 | $562.34 | $7,413.10 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $870.96 | Professional | None | $354.81 | $549.54 | $870.96 |
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 $229.09 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $338.84 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $346.74 |
Where Virginia sits
The same service costs 9.5 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· 45th of 51
$513
OK $3,236UT $339
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.