How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,585 to $13,490Professionalmedian $1,778 · 10th to 90th $1,479 to $2,570
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 $1,862.09 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,862.09 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,698.24 | $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 $1,548.82 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $295.12 Typical High $354.81 | Professional | 80 · Assistant surgeon | $245.47 | $295.12 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | AS · PA/NP assist | $213.80 | $257.04 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,778.28 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,630.78 Typical High $7,244.36 | Facility | None | $512.86 | $3,630.78 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,548.82 | $1,659.59 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,659.59 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,137.96 | $2,818.38 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $3,019.95 | Facility | None | $1,862.09 | $2,238.72 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,995.26 | $2,137.96 | $2,137.96 |
Sentara Setting Facility Modifier None Typical Low $1,230.27 Median $2,691.53 Typical High $10,232.93 | Facility | None | $1,230.27 | $2,691.53 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,513.56 | $2,041.74 | $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 $1,148.15 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,548.82 | $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 $851.14 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,318.26 | $1,318.26 |
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· 35th of 51
$1,862
AK $6,607TX $324
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.