How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,905 to $13,804Professionalmedian $3,162 · 10th to 90th $2,455 to $4,365
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 $3,162.28 Median $5,888.44 Typical High $14,125.38 | Facility | None | $3,162.28 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $3,235.94 | Professional | None | $2,884.03 | $3,162.28 | $3,235.94 |
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 $2,630.27 Median $3,162.28 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,162.28 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $501.19 Typical High $602.56 | Professional | 80 · Assistant surgeon | $416.87 | $501.19 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $436.52 Typical High $524.81 | Professional | AS · PA/NP assist | $363.08 | $436.52 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $3,715.35 | Professional | None | $2,884.03 | $3,162.28 | $3,715.35 |
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 $2,454.71 Median $2,818.38 Typical High $4,365.16 | Professional | None | $2,454.71 | $2,818.38 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,290.87 | $2,754.23 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $3,981.07 Median $4,897.79 Typical High $4,897.79 | Professional | None | $3,981.07 | $4,897.79 | $4,897.79 |
Medcost Setting Facility Modifier None Typical Low $3,162.28 Median $3,801.89 Typical High $5,248.07 | Facility | None | $3,162.28 | $3,801.89 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $3,467.37 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,467.37 | $3,981.07 | $3,981.07 |
Sentara Setting Facility Modifier None Typical Low $2,041.74 Median $3,467.37 Typical High $11,481.54 | Facility | None | $2,041.74 | $3,467.37 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $6,606.93 | Professional | None | $2,691.53 | $3,467.37 | $6,606.93 |
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 $1,949.84 Median $2,630.27 Typical High $5,248.07 | Professional | None | $1,949.84 | $2,630.27 | $5,248.07 |
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 $1,445.44 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,445.44 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $575.44 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,137.96 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,238.72 | $2,238.72 |
Where Virginia sits
The same service costs 20.9 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· 35th of 51
$3,162
AK $11,220TX $537
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.