How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,380 to $10,965Professionalmedian $1,905 · 10th to 90th $1,585 to $2,692
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 $1,995.26 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,995.26 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,698.24 | $1,819.70 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,905.46 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $331.13 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,862.09 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,995.26 Typical High $3,715.35 | Facility | None | $645.65 | $1,995.26 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,513.56 | $1,778.28 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,819.70 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,187.76 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $3,235.94 | Facility | None | $1,995.26 | $2,187.76 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Sentara Setting Facility Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,348.96 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $8,128.31 | Professional | None | $1,380.38 | $2,089.30 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,819.70 | $3,162.28 |
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 $812.83 Median $891.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $812.83 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 53 · Discontinued | $323.59 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $269.15 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | 56 · Pre-op care only | $162.18 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,412.54 |
Where Virginia sits
The same service costs 8.7 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· 33rd of 51
$1,950
AK $7,244TX $832
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.