How much rates vary
Facilitymedian $4,677 · 10th to 90th $851 to $14,125Professionalmedian $871 · 10th to 90th $692 to $1,349
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 $851.14 Median $5,495.41 Typical High $14,125.38 | Facility | None | $851.14 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $870.96 | Professional | None | $630.96 | $851.14 | $870.96 |
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 $724.44 Median $851.14 Typical High $1,096.48 | Professional | None | $724.44 | $851.14 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $691.83 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $173.78 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $154.88 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $5,495.41 | Professional | None | $794.33 | $870.96 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $6,165.95 | Facility | None | $512.86 | $3,090.30 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,318.26 | Professional | None | $707.95 | $851.14 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | None | $977.24 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,380.38 | Facility | None | $851.14 | $1,071.52 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $691.83 Median $2,041.74 Typical High $10,471.29 | Facility | None | $691.83 | $2,041.74 | $10,471.29 |
Sentara Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $6,025.60 | Professional | None | $758.58 | $1,000.00 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,513.56 | Professional | None | $630.96 | $1,000.00 | $1,513.56 |
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 $316.23 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $478.63 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $95.50 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $446.68 | $588.84 | $588.84 |
Where Virginia sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 38th of 51
$912
OK $3,548TX $525
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.