How much rates vary
Facilitymedian $3,388 · 10th to 90th $513 to $9,550Professionalmedian $490 · 10th to 90th $389 to $776
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 $467.74 Median $5,370.32 Typical High $14,125.38 | Facility | None | $467.74 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $3,981.07 | Professional | None | $371.54 | $467.74 | $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 $416.87 Median $489.78 Typical High $630.96 | Professional | None | $416.87 | $489.78 | $630.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $309.03 Typical High $398.11 | Professional | 62 · Two surgeons | $263.03 | $309.03 | $398.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $79.43 Typical High $102.33 | Professional | 80 · Assistant surgeon | $66.07 | $79.43 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $57.54 Median $69.18 Typical High $89.13 | Professional | AS · PA/NP assist | $57.54 | $69.18 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $2,511.89 | Professional | None | $426.58 | $478.63 | $2,511.89 |
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 $407.38 Median $489.78 Typical High $741.31 | Professional | None | $407.38 | $489.78 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $562.34 | Professional | None | $371.54 | $446.68 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $660.69 | Professional | None | $524.81 | $660.69 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $467.74 Median $562.34 Typical High $758.58 | Facility | None | $467.74 | $562.34 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $1,513.56 Typical High $8,709.64 | Facility | None | $371.54 | $1,513.56 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $4,570.88 | Professional | None | $380.19 | $549.54 | $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 $346.74 Median $537.03 Typical High $831.76 | Professional | None | $346.74 | $537.03 | $831.76 |
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 $186.21 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $186.21 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $74.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $275.42 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $257.04 | $323.59 | $323.59 |
Where Virginia sits
The same service costs 7.1 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· 40th of 51
$525
AK $2,042UT $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.