How much rates vary
Facilitymedian $6,761 · 10th to 90th $2,042 to $15,488Professionalmedian $3,090 · 10th to 90th $2,399 to $4,266
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 $3,235.94 Median $5,888.44 Typical High $14,125.38 | Facility | None | $3,235.94 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,951.21 | $3,235.94 | $3,235.94 |
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 $2,630.27 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,162.28 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $512.86 Typical High $616.60 | Professional | 80 · Assistant surgeon | $426.58 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $446.68 Typical High $537.03 | Professional | AS · PA/NP assist | $371.54 | $446.68 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $2,754.23 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,754.23 | $3,090.30 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,467.37 Typical High $7,079.46 | Facility | None | $630.96 | $3,467.37 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,818.38 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,630.78 | Professional | None | $2,454.71 | $2,884.03 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $3,548.13 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,548.13 | $4,466.84 | $4,466.84 |
Medcost Setting Facility Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $5,248.07 | Facility | None | $3,235.94 | $3,467.37 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $4,265.80 | Professional | None | $3,090.30 | $3,801.89 | $4,265.80 |
Sentara Setting Facility Modifier None Typical Low $2,041.74 Median $3,801.89 Typical High $12,302.69 | Facility | None | $2,041.74 | $3,801.89 | $12,302.69 |
Sentara Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $6,606.93 | Professional | None | $2,290.87 | $3,090.30 | $6,606.93 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,511.89 | $5,128.61 |
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 $1,445.44 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,445.44 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,187.76 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,238.72 | $2,238.72 |
Where Virginia sits
The same service costs 19.5 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· 35th of 51
$3,090
AK $11,482TX $589
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.