How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,738 to $13,490Professionalmedian $2,570 · 10th to 90th $2,089 to $3,548
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 $2,630.27 Median $5,888.44 Typical High $14,125.38 | Facility | None | $2,630.27 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $2,884.03 | Professional | None | $2,398.83 | $2,630.27 | $2,884.03 |
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 $2,137.96 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,570.40 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,621.81 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,348.96 | $1,621.81 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $407.38 Typical High $489.78 | Professional | 80 · Assistant surgeon | $346.74 | $407.38 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $363.08 Typical High $426.58 | Professional | AS · PA/NP assist | $302.00 | $363.08 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,398.83 | $2,630.27 | $3,090.30 |
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 $2,187.76 Median $2,290.87 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,290.87 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,344.23 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,090.30 | $3,890.45 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $4,265.80 | Facility | None | $2,630.27 | $3,019.95 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,884.03 | $3,235.94 | $3,235.94 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $3,019.95 Typical High $10,715.19 | Facility | None | $1,737.80 | $3,019.95 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $5,370.32 | Professional | None | $2,137.96 | $2,754.23 | $5,370.32 |
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 $1,621.81 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,621.81 | $2,089.30 | $4,265.80 |
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 $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $478.63 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $1,819.70 |
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· 33rd of 51
$2,630
AK $9,333TX $427
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.