How much rates vary
Facilitymedian $3,388 · 10th to 90th $398 to $9,550Professionalmedian $380 · 10th to 90th $295 to $589
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 $354.81 Median $5,370.32 Typical High $14,125.38 | Facility | None | $354.81 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $3,981.07 | Professional | None | $288.40 | $354.81 | $3,981.07 |
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 $323.59 Median $380.19 Typical High $489.78 | Professional | None | $323.59 | $380.19 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $575.44 Typical High $741.31 | Professional | 50 · Both sides | $478.63 | $575.44 | $741.31 |
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 $69.18 | Professional | AS · PA/NP assist | $44.67 | $53.70 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $758.58 | Professional | None | $338.84 | $371.54 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $3,311.31 | Facility | None | $524.81 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $562.34 | Professional | None | $316.23 | $363.08 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | None | $295.12 | $354.81 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | None | $407.38 | $501.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $575.44 | Facility | None | $354.81 | $416.87 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Sentara Setting Facility Modifier None Typical Low $275.42 Median $1,445.44 Typical High $8,709.64 | Facility | None | $275.42 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $4,570.88 | Professional | None | $288.40 | $416.87 | $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 $263.03 Median $416.87 Typical High $630.96 | Professional | None | $263.03 | $416.87 | $630.96 |
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 $144.54 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $57.54 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $43.65 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.84 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $204.17 | $245.47 | $245.47 |
Where Virginia sits
The same service costs 11.7 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· 39th of 51
$407
OK $2,754UT $234
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.