How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,349 to $13,490Professionalmedian $1,479 · 10th to 90th $1,202 to $2,138
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 $1,584.89 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,584.89 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,584.89 | $1,737.80 |
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 $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,238.72 Typical High $2,691.53 | Professional | 50 · Both sides | $1,862.09 | $2,238.72 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $288.40 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $251.19 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,380.38 | $1,548.82 | $1,819.70 |
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 $1,318.26 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,348.96 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,412.54 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,621.81 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,570.40 | Facility | None | $1,584.89 | $1,862.09 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,584.89 | $1,737.80 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,023.29 | $1,659.59 | $3,235.94 |
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 $912.01 Median $1,288.25 Typical High $2,454.71 | Professional | None | $912.01 | $1,288.25 | $2,454.71 |
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 $691.83 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,122.02 |
Where Virginia sits
The same service costs 18.6 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· 36th of 51
$1,549
AK $5,370TX $288
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.