How much rates vary
Facilitymedian $6,026 · 10th to 90th $977 to $21,878Professionalmedian $1,000 · 10th to 90th $813 to $1,413
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 $1,023.29 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,023.29 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,380.38 | Professional | None | $954.99 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $21,877.62 Median $28,183.83 Typical High $30,199.52 | Facility | None | $21,877.62 | $28,183.83 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,230.27 | Professional | None | $851.14 | $1,023.29 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,548.82 Typical High $1,862.09 | Professional | 50 · Both sides | $1,288.25 | $1,548.82 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $645.65 Typical High $776.25 | Professional | 62 · Two surgeons | $537.03 | $645.65 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $194.98 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $144.54 Typical High $173.78 | Professional | AS · PA/NP assist | $120.23 | $144.54 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,318.26 | Professional | None | $912.01 | $1,000.00 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,801.89 Typical High $9,772.37 | Facility | None | $724.44 | $3,801.89 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,380.38 | Professional | None | $851.14 | $912.01 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,202.26 | Professional | None | $812.83 | $977.24 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,659.59 | Facility | None | $1,023.29 | $1,174.90 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,288.25 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $2,454.71 Typical High $12,302.69 | Facility | None | $812.83 | $2,454.71 | $12,302.69 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $2,137.96 | Professional | None | $812.83 | $1,096.48 | $2,137.96 |
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 $630.96 Median $812.83 Typical High $1,621.81 | Professional | None | $630.96 | $812.83 | $1,621.81 |
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 $467.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $707.95 |
Where Virginia sits
The same service costs 7.9 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· 36th of 51
$1,023
AK $3,715TX $468
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.