How much rates vary
Facilitymedian $3,715 · 10th to 90th $661 to $10,233Professionalmedian $617 · 10th to 90th $501 to $1,000
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 $588.84 Median $6,165.95 Typical High $11,481.54 | Facility | None | $588.84 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $4,365.16 | Professional | None | $467.74 | $588.84 | $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 $524.81 Median $616.60 Typical High $794.33 | Professional | None | $524.81 | $616.60 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $100.00 Typical High $125.89 | Professional | 80 · Assistant surgeon | $83.18 | $100.00 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $87.10 Typical High $112.20 | Professional | AS · PA/NP assist | $72.44 | $87.10 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $4,897.79 | Professional | None | $537.03 | $602.56 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $4,365.16 | Facility | None | $724.44 | $2,344.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $933.25 | Professional | None | $512.86 | $616.60 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $691.83 | Professional | None | $467.74 | $562.34 | $691.83 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $870.96 | Professional | None | $707.95 | $870.96 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $588.84 Median $741.31 Typical High $977.24 | Facility | None | $588.84 | $741.31 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Sentara Setting Facility Modifier None Typical Low $489.78 Median $1,737.80 Typical High $8,709.64 | Facility | None | $489.78 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $4,570.88 | Professional | None | $501.19 | $724.44 | $4,570.88 |
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 $446.68 Median $707.95 Typical High $1,071.52 | Professional | None | $446.68 | $707.95 | $1,071.52 |
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 $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $93.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $346.74 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $69.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $46.77 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $323.59 | $416.87 | $416.87 |
Where Virginia sits
The same service costs 8.3 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· 43rd of 51
$661
OK $2,951UT $355
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.