How much rates vary
Facilitymedian $4,467 · 10th to 90th $501 to $16,596Professionalmedian $389 · 10th to 90th $309 to $603
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 $363.08 Median $4,786.30 Typical High $10,000.00 | Facility | None | $363.08 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $2,570.40 | Professional | None | $281.84 | $363.08 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $10,715.19 Typical High $19,952.62 | Facility | None | $4,466.84 | $10,715.19 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $489.78 | Professional | None | $316.23 | $380.19 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $61.66 Typical High $79.43 | Professional | 80 · Assistant surgeon | $51.29 | $61.66 | $79.43 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $44.67 Median $53.70 Typical High $67.61 | Professional | AS · PA/NP assist | $44.67 | $53.70 | $67.61 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $501.19 | Professional | None | $346.74 | $389.05 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,495.41 | Facility | None | $501.19 | $1,174.90 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $575.44 | Professional | None | $316.23 | $380.19 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $436.52 | Professional | None | $288.40 | $346.74 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | None | $446.68 | $549.54 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $602.56 | Facility | None | $363.08 | $446.68 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Sentara Setting Facility Modifier None Typical Low $295.12 Median $1,071.52 Typical High $7,413.10 | Facility | None | $295.12 | $1,071.52 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $2,137.96 | Professional | None | $316.23 | $426.58 | $2,137.96 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $645.65 | Professional | None | $275.42 | $436.52 | $645.65 |
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 $141.25 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $141.25 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $57.54 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $213.80 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $42.66 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.18 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $199.53 | $257.04 | $257.04 |
Where Virginia sits
The same service costs 5.8 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· 39th of 51
$417
AK $1,380UT $240
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.