How much rates vary
Facilitymedian $3,020 · 10th to 90th $550 to $9,550Professionalmedian $501 · 10th to 90th $417 to $708
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 $549.54 Median $4,786.30 Typical High $10,000.00 | Facility | None | $549.54 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $645.65 | Professional | None | $478.63 | $549.54 | $645.65 |
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 $426.58 Median $512.86 Typical High $616.60 | Professional | None | $426.58 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $776.25 Typical High $933.25 | Professional | 50 · Both sides | $645.65 | $776.25 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $83.18 Typical High $97.72 | Professional | 80 · Assistant surgeon | $69.18 | $83.18 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $72.44 Typical High $87.10 | Professional | AS · PA/NP assist | $60.26 | $72.44 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $645.65 | Professional | None | $436.52 | $489.78 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $2,187.76 | Facility | None | $478.63 | $1,071.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $707.95 | Professional | None | $426.58 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $630.96 | Professional | None | $416.87 | $501.19 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $707.95 | Professional | None | $549.54 | $707.95 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $549.54 Median $602.56 Typical High $891.25 | Facility | None | $549.54 | $602.56 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $1,318.26 | Professional | None | $537.03 | $562.34 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $407.38 Median $1,737.80 Typical High $8,709.64 | Facility | None | $407.38 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $1,148.15 | Professional | None | $457.09 | $549.54 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $851.14 | Professional | None | $316.23 | $426.58 | $851.14 |
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 $239.88 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $354.81 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $331.13 | $380.19 | $380.19 |
Where Virginia sits
The same service costs 5.8 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· 36th of 51
$525
AK $1,862UT $324
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.