How much rates vary
Facilitymedian $5,754 · 10th to 90th $661 to $15,488Professionalmedian $676 · 10th to 90th $550 to $1,072
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 $660.69 Median $5,623.41 Typical High $10,964.78 | Facility | None | $660.69 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $4,365.16 | Professional | None | $588.84 | $660.69 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,589.25 | Facility | None | $8,511.38 | $11,220.18 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $851.14 | Professional | None | $562.34 | $676.08 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $426.58 Typical High $537.03 | Professional | 62 · Two surgeons | $354.81 | $426.58 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $107.15 Typical High $138.04 | Professional | 80 · Assistant surgeon | $89.13 | $107.15 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $93.33 Typical High $120.23 | Professional | AS · PA/NP assist | $79.43 | $93.33 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $5,495.41 | Professional | None | $616.60 | $691.83 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $5,754.40 | Facility | None | $645.65 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,023.29 | Professional | None | $588.84 | $660.69 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $758.58 | Professional | None | $512.86 | $616.60 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | None | $758.58 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $1,071.52 | Facility | None | $660.69 | $776.25 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Sentara Setting Facility Modifier None Typical Low $537.03 Median $2,137.96 Typical High $10,715.19 | Facility | None | $537.03 | $2,137.96 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $7,413.10 | Professional | None | $549.54 | $758.58 | $7,413.10 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $1,148.15 | Professional | None | $467.74 | $776.25 | $1,148.15 |
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 $288.40 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $457.09 |
Where Virginia sits
The same service costs 8.3 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· 42nd of 51
$708
OK $3,548UT $427
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.