How much rates vary
Facilitymedian $2,344 · 10th to 90th $501 to $11,482Professionalmedian $794 · 10th to 90th $646 to $1,000
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 $831.76 Median $5,623.41 Typical High $15,848.93 | Facility | None | $831.76 | $5,623.41 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $831.76 | Professional | None | $758.58 | $794.33 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $22,387.21 Typical High $38,018.94 | Facility | None | $12,589.25 | $22,387.21 | $38,018.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,000.00 | Professional | None | $691.83 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $158.49 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $114.82 Typical High $141.25 | Professional | AS · PA/NP assist | $97.72 | $114.82 | $141.25 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,122.02 | Professional | None | $691.83 | $794.33 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | None | $977.24 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,288.25 | Facility | None | $794.33 | $954.99 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $707.95 | Professional | None | $537.03 | $588.84 | $707.95 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $933.25 Typical High $10,232.93 | Facility | None | $616.60 | $933.25 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,148.15 | Professional | None | $660.69 | $776.25 | $1,148.15 |
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 $549.54 Median $660.69 Typical High $1,174.90 | Professional | None | $549.54 | $660.69 | $1,174.90 |
4 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 54 · Surgery only Typical Low $575.44 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $549.54 | $575.44 |
Where Virginia sits
The same service costs 3.8 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· 21st of 51
$794
AK $1,862TX $490
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.