How much rates vary
Facilitymedian $5,370 · 10th to 90th $537 to $14,791Professionalmedian $550 · 10th to 90th $437 to $871
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 $537.03 Median $5,370.32 Typical High $14,125.38 | Facility | None | $537.03 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $3,235.94 | Professional | None | $407.38 | $537.03 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $707.95 | Professional | None | $467.74 | $549.54 | $707.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $346.74 Typical High $446.68 | Professional | 62 · Two surgeons | $295.12 | $346.74 | $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 $64.57 Median $77.62 Typical High $100.00 | Professional | AS · PA/NP assist | $64.57 | $77.62 | $100.00 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $6,918.31 | Professional | None | $489.78 | $537.03 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $6,165.95 | Facility | None | $524.81 | $3,019.95 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $831.76 | Professional | None | $457.09 | $524.81 | $831.76 |
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 $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $870.96 | Facility | None | $537.03 | $676.08 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Sentara Setting Facility Modifier None Typical Low $407.38 Median $1,737.80 Typical High $11,481.54 | Facility | None | $407.38 | $1,737.80 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $7,413.10 | Professional | None | $426.58 | $616.60 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $933.25 | Professional | None | $398.11 | $602.56 | $933.25 |
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 $204.17 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $288.40 | $371.54 | $371.54 |
Where Virginia sits
The same service costs 11.2 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· 40th of 51
$589
OK $3,981UT $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.