How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,380 to $13,490Professionalmedian $1,479 · 10th to 90th $1,175 to $2,089
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 $1,548.82 Median $5,495.41 Typical High $10,964.78 | Facility | None | $1,548.82 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,548.82 | $1,949.84 |
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 $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $288.40 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $251.19 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,513.56 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,019.95 Typical High $5,754.40 | Facility | None | $512.86 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,348.96 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,412.54 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,737.80 | $2,137.96 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,511.89 | Facility | None | $1,548.82 | $1,778.28 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,621.81 | $1,621.81 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $1,047.13 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,047.13 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,047.13 | $1,584.89 | $3,162.28 |
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 $912.01 Median $1,230.27 Typical High $2,398.83 | Professional | None | $912.01 | $1,230.27 | $2,398.83 |
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 $691.83 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,071.52 |
Where Virginia sits
The same service costs 15.1 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
$1,514
AK $5,370TX $355
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.