How much rates vary
Facilitymedian $7,586 · 10th to 90th $933 to $16,982Professionalmedian $933 · 10th to 90th $741 to $1,479
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 $2,884.03 Median $8,317.64 Typical High $16,595.87 | Facility | None | $2,884.03 | $8,317.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $4,365.16 | Professional | None | $676.08 | $912.01 | $4,365.16 |
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 $758.58 Median $912.01 Typical High $1,174.90 | Professional | None | $758.58 | $912.01 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $186.21 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $13,489.63 | Professional | None | $794.33 | $870.96 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,897.79 Typical High $9,772.37 | Facility | None | $512.86 | $4,897.79 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,412.54 | Professional | None | $741.31 | $933.25 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | None | $691.83 | $831.76 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,479.11 | Facility | None | $912.01 | $1,096.48 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $2,454.71 Typical High $12,882.50 | Facility | None | $812.83 | $2,454.71 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $7,413.10 | Professional | None | $812.83 | $1,071.52 | $7,413.10 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,621.81 | Professional | None | $676.08 | $1,096.48 | $1,621.81 |
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 $338.84 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $338.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $512.86 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $478.63 | $630.96 | $630.96 |
Where Virginia sits
The same service costs 11.0 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· 40th of 51
$955
OK $5,888UT $537
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.