How much rates vary
Facilitymedian $10,000 · 10th to 90th $2,399 to $21,878Professionalmedian $2,754 · 10th to 90th $2,239 to $3,890
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 $2,818.38 Median $7,244.36 Typical High $14,125.38 | Facility | None | $2,818.38 | $7,244.36 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,090.30 | Professional | None | $2,570.40 | $2,818.38 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,754.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,737.80 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,445.44 | $1,737.80 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $446.68 Typical High $537.03 | Professional | 80 · Assistant surgeon | $371.54 | $446.68 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $389.05 Typical High $467.74 | Professional | AS · PA/NP assist | $323.59 | $389.05 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,570.40 | $2,818.38 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,709.64 Typical High $17,378.01 | Facility | None | $512.86 | $8,709.64 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,511.89 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,089.30 | $2,511.89 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $3,311.31 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,311.31 | $4,265.80 | $4,265.80 |
Medcost Setting Facility Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $4,570.88 | Facility | None | $2,818.38 | $3,388.44 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $3,235.94 | Professional | None | $2,754.23 | $3,162.28 | $3,235.94 |
Sentara Setting Facility Modifier None Typical Low $1,778.28 Median $3,981.07 Typical High $18,620.87 | Facility | None | $1,778.28 | $3,981.07 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $5,888.44 | Professional | None | $2,454.71 | $3,235.94 | $5,888.44 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $4,570.88 | Professional | None | $1,737.80 | $2,344.23 | $4,570.88 |
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 $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,905.46 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,949.84 | $1,949.84 |
Where Virginia sits
The same service costs 25.7 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
$2,818
AK $10,000TX $389
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.