How much rates vary
Facilitymedian $2,884 · 10th to 90th $363 to $9,550Professionalmedian $331 · 10th to 90th $263 to $525
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 $389.05 Median $3,801.89 Typical High $9,332.54 | Facility | None | $389.05 | $3,801.89 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $2,041.74 | Professional | None | $245.47 | $309.03 | $2,041.74 |
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 $275.42 Median $323.59 Typical High $416.87 | Professional | None | $275.42 | $323.59 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $489.78 Typical High $630.96 | Professional | 50 · Both sides | $407.38 | $489.78 | $630.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $169.82 Median $204.17 Typical High $263.03 | Professional | 62 · Two surgeons | $169.82 | $204.17 | $263.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $52.48 Typical High $66.07 | Professional | 80 · Assistant surgeon | $43.65 | $52.48 | $66.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $45.71 Typical High $58.88 | Professional | AS · PA/NP assist | $38.02 | $45.71 | $58.88 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $2,511.89 | Professional | None | $295.12 | $331.13 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $3,388.44 | Facility | None | $512.86 | $1,819.70 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $478.63 | Professional | None | $269.15 | $323.59 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $363.08 | Professional | None | $245.47 | $295.12 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | None | $380.19 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $380.19 Typical High $512.86 | Facility | None | $309.03 | $380.19 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $1,288.25 Typical High $8,709.64 | Facility | None | $257.04 | $1,288.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $4,570.88 | Professional | None | $269.15 | $371.54 | $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 $234.42 Median $380.19 Typical High $562.34 | Professional | None | $234.42 | $380.19 | $562.34 |
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 $120.23 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $48.98 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $181.97 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $24.55 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $218.78 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $169.82 | $218.78 | $218.78 |
Where Virginia sits
The same service costs 6.0 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· 44th of 51
$347
OK $1,479UT $245
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.