How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $13,490Professionalmedian $1,288 · 10th to 90th $1,047 to $1,820
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 $1,348.96 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,348.96 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,348.96 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $977.24 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $245.47 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $213.80 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,818.38 Typical High $5,754.40 | Facility | None | $524.81 | $2,818.38 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,174.90 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,202.26 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,238.72 | Facility | None | $1,348.96 | $1,659.59 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,380.38 | $1,584.89 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,570.40 Typical High $10,232.93 | Facility | None | $933.25 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,000.00 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,000.00 | $1,479.11 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,187.76 | Professional | None | $831.76 | $1,148.15 | $2,187.76 |
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 $588.84 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $954.99 | $954.99 |
Where Virginia sits
The same service costs 16.6 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
$1,318
AK $4,677TX $282
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.