How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,692 to $26,915Professionalmedian $3,631 · 10th to 90th $2,884 to $5,012
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 $3,388.44 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,388.44 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,388.44 | $3,715.35 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,630.78 Typical High $4,365.16 | Professional | None | $3,019.95 | $3,630.78 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,570.88 Median $5,495.41 Typical High $6,606.93 | Professional | 50 · Both sides | $4,570.88 | $5,495.41 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,290.87 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,905.46 | $2,290.87 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $588.84 Typical High $707.95 | Professional | 80 · Assistant surgeon | $489.78 | $588.84 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $512.86 Typical High $616.60 | Professional | AS · PA/NP assist | $426.58 | $512.86 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $3,467.37 Median $3,801.89 Typical High $4,466.84 | Professional | None | $3,467.37 | $3,801.89 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $13,182.57 Typical High $26,302.68 | Facility | None | $512.86 | $13,182.57 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $5,128.61 | Professional | None | $2,691.53 | $3,235.94 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,311.31 Typical High $4,168.69 | Professional | None | $2,754.23 | $3,311.31 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $4,466.84 Median $5,623.41 Typical High $5,623.41 | Professional | None | $4,466.84 | $5,623.41 | $5,623.41 |
Medcost Setting Facility Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $6,025.60 | Facility | None | $3,715.35 | $3,981.07 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $3,890.45 Median $5,370.32 Typical High $5,370.32 | Professional | None | $3,890.45 | $5,370.32 | $5,370.32 |
Sentara Setting Facility Modifier None Typical Low $2,238.72 Median $4,365.16 Typical High $18,620.87 | Facility | None | $2,238.72 | $4,365.16 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $7,585.78 | Professional | None | $3,019.95 | $3,801.89 | $7,585.78 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $5,888.44 | Professional | None | $2,290.87 | $2,951.21 | $5,888.44 |
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 $1,659.59 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,659.59 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $676.08 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,511.89 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,570.40 | $2,570.40 |
Where Virginia sits
The same service costs 20.4 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· 36th of 51
$3,631
AK $13,183TX $646
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.