How much rates vary
Facilitymedian $6,761 · 10th to 90th $933 to $17,378Professionalmedian $813 · 10th to 90th $617 to $1,259
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 $776.25 Median $5,370.32 Typical High $14,125.38 | Facility | None | $776.25 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $2,041.74 | Professional | None | $588.84 | $776.25 | $2,041.74 |
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 $676.08 Median $794.33 Typical High $1,023.29 | Professional | None | $676.08 | $794.33 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $501.19 Typical High $645.65 | Professional | 62 · Two surgeons | $416.87 | $501.19 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $144.54 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,071.52 | Professional | None | $724.44 | $812.83 | $1,071.52 |
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 $660.69 Median $794.33 Typical High $1,202.26 | Professional | None | $660.69 | $794.33 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $891.25 | Professional | None | $602.56 | $724.44 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $933.25 | $1,174.90 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,258.93 | Facility | None | $776.25 | $933.25 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Sentara Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $10,232.93 | Facility | None | $602.56 | $1,905.46 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $6,025.60 | Professional | None | $602.56 | $912.01 | $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 $575.44 Median $933.25 Typical High $1,380.38 | Professional | None | $575.44 | $933.25 | $1,380.38 |
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 $295.12 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $537.03 | $537.03 |
Where Virginia sits
The same service costs 6.9 times more in Oklahoma than in Texas. 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· 36th of 51
$871
OK $3,020TX $437
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.