How much rates vary
Facilitymedian $4,677 · 10th to 90th $794 to $16,982Professionalmedian $1,023 · 10th to 90th $832 to $1,549
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 $1,000.00 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,000.00 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | None | $870.96 | $1,000.00 | $1,000.00 |
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 $851.14 Median $1,023.29 Typical High $1,288.25 | Professional | None | $851.14 | $1,023.29 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $162.18 Typical High $208.93 | Professional | 80 · Assistant surgeon | $134.90 | $162.18 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $181.97 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,348.96 | Professional | None | $933.25 | $1,023.29 | $1,348.96 |
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 $870.96 Median $1,000.00 Typical High $1,513.56 | Professional | None | $870.96 | $1,000.00 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,122.02 | Professional | None | $758.58 | $912.01 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,548.82 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,174.90 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $7,413.10 | Facility | None | $741.31 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $2,290.87 | Professional | None | $794.33 | $1,148.15 | $2,290.87 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,778.28 | Professional | None | $741.31 | $1,148.15 | $1,778.28 |
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 $416.87 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $691.83 |
Where Virginia sits
The same service costs 6.6 times more in Alaska 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· 30th of 51
$1,072
AK $2,884TX $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.