How much rates vary
Facilitymedian $10,233 · 10th to 90th $3,020 to $26,915Professionalmedian $4,365 · 10th to 90th $3,548 to $6,166
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 $3,801.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,801.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $5,495.41 | Professional | None | $4,073.80 | $4,466.84 | $5,495.41 |
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 $3,630.78 Median $4,365.16 Typical High $5,248.07 | Professional | None | $3,630.78 | $4,365.16 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $5,495.41 Median $6,606.93 Typical High $7,943.28 | Professional | 50 · Both sides | $5,495.41 | $6,606.93 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,290.87 Median $2,754.23 Typical High $3,311.31 | Professional | 62 · Two surgeons | $2,290.87 | $2,754.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $707.95 Typical High $851.14 | Professional | 80 · Assistant surgeon | $588.84 | $707.95 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $616.60 Typical High $741.31 | Professional | AS · PA/NP assist | $512.86 | $616.60 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $5,370.32 | Professional | None | $4,168.69 | $4,570.88 | $5,370.32 |
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 $3,715.35 Median $3,981.07 Typical High $6,309.57 | Professional | None | $3,715.35 | $3,981.07 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $5,011.87 | Professional | None | $3,311.31 | $3,981.07 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $5,623.41 Median $7,079.46 Typical High $7,079.46 | Professional | None | $5,623.41 | $7,079.46 | $7,079.46 |
Medcost Setting Facility Modifier None Typical Low $4,466.84 Median $5,370.32 Typical High $7,244.36 | Facility | None | $4,466.84 | $5,370.32 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $5,128.61 Median $6,025.60 Typical High $6,025.60 | Professional | None | $5,128.61 | $6,025.60 | $6,025.60 |
Sentara Setting Facility Modifier None Typical Low $2,454.71 Median $5,128.61 Typical High $18,620.87 | Facility | None | $2,454.71 | $5,128.61 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $3,630.78 Median $5,011.87 Typical High $9,120.11 | Professional | None | $3,630.78 | $5,011.87 | $9,120.11 |
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 $2,754.23 Median $3,715.35 Typical High $7,244.36 | Professional | None | $2,754.23 | $3,715.35 | $7,244.36 |
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 $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $2,041.74 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $812.83 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $3,019.95 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,162.28 | $3,162.28 |
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· 37th of 51
$4,467
AK $15,849TX $776
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.