How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,549 to $13,490Professionalmedian $1,820 · 10th to 90th $1,445 to $2,512
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 $1,659.59 Median $5,495.41 Typical High $10,964.78 | Facility | None | $1,659.59 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,659.59 | $1,862.09 | $2,089.30 |
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 $1,513.56 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,819.70 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | 62 · Two surgeons | $954.99 | $1,122.02 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $346.74 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $302.00 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,862.09 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,715.35 Typical High $7,244.36 | Facility | None | $512.86 | $3,715.35 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,621.81 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,698.24 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,511.89 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $3,090.30 | Facility | None | $1,862.09 | $2,187.76 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,819.70 | $1,819.70 | $2,089.30 |
Sentara Setting Facility Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $10,232.93 | Facility | None | $1,202.26 | $2,630.27 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $3,890.45 | Professional | None | $1,202.26 | $1,949.84 | $3,890.45 |
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 $1,096.48 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,513.56 | $2,951.21 |
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 $831.76 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $831.76 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,318.26 | $1,318.26 |
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
$1,862
AK $6,457TX $331
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.