How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,288 to $13,490Professionalmedian $1,413 · 10th to 90th $1,122 to $1,950
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 $1,445.44 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,445.44 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,445.44 | $1,698.24 |
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 $1,202.26 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,445.44 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,137.96 Typical High $2,570.40 | Professional | 50 · Both sides | $1,778.28 | $2,137.96 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,071.52 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,513.56 | $1,778.28 |
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 $1,148.15 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,288.25 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,344.23 | Facility | None | $1,445.44 | $1,621.81 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,380.38 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,000.00 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,445.44 | $3,019.95 |
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 $891.25 Median $1,148.15 Typical High $2,344.23 | Professional | None | $891.25 | $1,148.15 | $2,344.23 |
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 $660.69 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,000.00 |
Where Virginia sits
The same service costs 17.8 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
$1,445
AK $5,129TX $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.