How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,622 to $15,488Professionalmedian $1,950 · 10th to 90th $1,514 to $2,630
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 $1,949.84 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,949.84 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,862.09 | $1,949.84 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,995.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,258.93 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,047.13 | $1,258.93 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | 80 · Assistant surgeon | $269.15 | $323.59 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $281.84 Typical High $338.84 | Professional | AS · PA/NP assist | $234.42 | $281.84 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,137.96 | Professional | None | $1,862.09 | $2,089.30 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $7,079.46 | Facility | None | $512.86 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,778.28 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,995.26 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,454.71 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,235.94 | Facility | None | $1,905.46 | $1,905.46 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,819.70 | $1,905.46 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $10,715.19 | Facility | None | $1,258.93 | $3,388.44 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $4,168.69 | Professional | None | $1,548.82 | $1,995.26 | $4,168.69 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $3,162.28 | Professional | None | $1,148.15 | $1,548.82 | $3,162.28 |
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 $933.25 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $933.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $371.54 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,412.54 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,348.96 | $1,348.96 |
Where Virginia sits
The same service costs 11.2 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· 34th of 51
$1,950
AK $7,244TX $646
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.