How much rates vary
Facilitymedian $2,754 · 10th to 90th $490 to $9,550Professionalmedian $490 · 10th to 90th $398 to $759
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 $4,365.16 Typical High $14,125.38 | Facility | None | $489.78 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $2,570.40 | Professional | None | $467.74 | $478.63 | $2,570.40 |
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 $398.11 Median $478.63 Typical High $602.56 | Professional | None | $398.11 | $478.63 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $707.95 Typical High $912.01 | Professional | 50 · Both sides | $588.84 | $707.95 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $75.86 Typical High $97.72 | Professional | 80 · Assistant surgeon | $63.10 | $75.86 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $66.07 Typical High $83.18 | Professional | AS · PA/NP assist | $54.95 | $66.07 | $83.18 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $758.58 | Professional | None | $416.87 | $457.09 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,023.29 Typical High $1,949.84 | Facility | None | $346.74 | $1,023.29 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $724.44 | Professional | None | $416.87 | $478.63 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $562.34 | Professional | None | $380.19 | $446.68 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | None | $524.81 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $776.25 | Facility | None | $478.63 | $630.96 | $776.25 |
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 $371.54 Median $1,584.89 Typical High $8,709.64 | Facility | None | $371.54 | $1,584.89 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $4,073.80 | Professional | None | $389.05 | $549.54 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $851.14 | Professional | None | $346.74 | $537.03 | $851.14 |
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 $223.87 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $89.13 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $338.84 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $338.84 |
Where Virginia sits
The same service costs 5.1 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· 44th of 51
$501
AK $1,698UT $331
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.