How much rates vary
Facilitymedian $3,388 · 10th to 90th $501 to $9,772Professionalmedian $490 · 10th to 90th $389 to $741
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 $457.09 Median $5,370.32 Typical High $14,125.38 | Facility | None | $457.09 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $758.58 | Professional | None | $363.08 | $457.09 | $758.58 |
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 $407.38 Median $489.78 Typical High $616.60 | Professional | None | $407.38 | $489.78 | $616.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $257.04 Median $302.00 Typical High $389.05 | Professional | 62 · Two surgeons | $257.04 | $302.00 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $77.62 Typical High $100.00 | Professional | 80 · Assistant surgeon | $64.57 | $77.62 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $67.61 Typical High $85.11 | Professional | AS · PA/NP assist | $56.23 | $67.61 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $1,659.59 | Professional | None | $416.87 | $467.74 | $1,659.59 |
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 $398.11 Median $467.74 Typical High $707.95 | Professional | None | $398.11 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $549.54 | Professional | None | $371.54 | $446.68 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $645.65 | Professional | None | $512.86 | $645.65 | $645.65 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $741.31 | Facility | None | $457.09 | $549.54 | $741.31 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Sentara Setting Facility Modifier None Typical Low $363.08 Median $1,479.11 Typical High $8,709.64 | Facility | None | $363.08 | $1,479.11 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $4,570.88 | Professional | None | $380.19 | $537.03 | $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 $338.84 Median $524.81 Typical High $812.83 | Professional | None | $338.84 | $524.81 | $812.83 |
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 $181.97 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $181.97 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $54.95 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $257.04 | $316.23 | $316.23 |
Where Virginia sits
The same service costs 10.2 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· 41st of 51
$513
OK $2,951UT $288
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.