How much rates vary
Facilitymedian $6,761 · 10th to 90th $977 to $17,378Professionalmedian $933 · 10th to 90th $741 to $1,445
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 $891.25 Median $7,079.46 Typical High $14,125.38 | Facility | None | $891.25 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $4,168.69 | Professional | None | $691.83 | $891.25 | $4,168.69 |
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 $776.25 Median $933.25 Typical High $1,174.90 | Professional | None | $776.25 | $933.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,380.38 Typical High $1,778.28 | Professional | 50 · Both sides | $1,148.15 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | 62 · Two surgeons | $489.78 | $588.84 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $190.55 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $165.96 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,230.27 | Professional | None | $831.76 | $933.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,380.38 | Professional | None | $758.58 | $933.25 | $1,380.38 |
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 Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,479.11 | Facility | None | $891.25 | $1,122.02 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $724.44 Median $2,238.72 Typical High $10,232.93 | Facility | None | $724.44 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $6,025.60 | Professional | None | $776.25 | $1,071.52 | $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 $676.08 Median $1,071.52 Typical High $1,621.81 | Professional | None | $676.08 | $1,071.52 | $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 $346.74 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $177.83 | $177.83 |
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 $69.18 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $89.13 | $89.13 |
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 6.2 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· 37th of 51
$1,000
AK $3,311UT $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.