How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,738 to $13,490Professionalmedian $2,188 · 10th to 90th $1,738 to $3,090
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 $2,187.76 Median $5,888.44 Typical High $14,125.38 | Facility | None | $2,187.76 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,187.76 | $2,454.71 |
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 $1,819.70 Median $2,187.76 Typical High $2,630.27 | Professional | None | $1,819.70 | $2,187.76 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,380.38 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,148.15 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | 80 · Assistant surgeon | $288.40 | $346.74 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $302.00 Typical High $363.08 | Professional | AS · PA/NP assist | $257.04 | $302.00 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,995.26 | $2,238.72 | $2,630.27 |
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 $1,905.46 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,905.46 | $1,995.26 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,949.84 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,818.38 | $3,467.37 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,630.78 | Facility | None | $2,187.76 | $2,691.53 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,570.40 | $2,818.38 | $2,818.38 |
Sentara Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $10,232.93 | Facility | None | $1,445.44 | $2,754.23 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,511.89 | $4,786.30 |
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 $1,348.96 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,348.96 | $1,862.09 | $3,548.13 |
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 $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,548.82 |
Where Virginia sits
The same service costs 21.9 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· 37th of 51
$2,188
AK $7,943TX $363
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.