How much rates vary
Facilitymedian $2,692 · 10th to 90th $851 to $7,413Professionalmedian $2,884 · 10th to 90th $2,344 to $3,981
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 $3,019.95 Median $5,888.44 Typical High $14,125.38 | Facility | None | $3,019.95 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,691.53 Typical High $3,981.07 | Professional | None | $2,511.89 | $2,691.53 | $3,981.07 |
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 $2,398.83 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,398.83 | $2,884.03 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,819.70 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,513.56 | $1,819.70 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $467.74 Typical High $562.34 | Professional | 80 · Assistant surgeon | $389.05 | $467.74 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $407.38 Typical High $501.19 | Professional | AS · PA/NP assist | $338.84 | $407.38 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,511.89 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,318.26 Typical High $3,019.95 | Facility | None | $645.65 | $1,318.26 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $2,691.53 Typical High $3,981.07 | Professional | None | $2,511.89 | $2,691.53 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,754.23 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,265.80 | Professional | None | $3,467.37 | $3,467.37 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $3,019.95 Median $3,467.37 Typical High $5,011.87 | Facility | None | $3,019.95 | $3,467.37 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Professional | None | $12,882.50 | $12,882.50 | $12,882.50 |
Sentara Setting Facility Modifier None Typical Low $1,071.52 Median $2,570.40 Typical High $10,000.00 | Facility | None | $1,071.52 | $2,570.40 | $10,000.00 |
Sentara Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $6,456.54 | Professional | None | $2,238.72 | $3,162.28 | $6,456.54 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,089.30 | $2,818.38 | $4,897.79 |
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 $1,230.27 Median $1,348.96 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,230.27 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $549.54 Typical High $616.60 | Professional | 53 · Discontinued | $489.78 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,041.74 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $2,041.74 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $407.38 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $302.00 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,905.46 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,905.46 | $2,137.96 |
Where Virginia sits
The same service costs 15.8 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· 27th of 51
$2,884
AK $8,128TX $513
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.