How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,122 to $16,982Professionalmedian $1,230 · 10th to 90th $955 to $1,778
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 $1,202.26 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,202.26 | $1,445.44 |
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 $1,096.48 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,905.46 Typical High $2,344.23 | Professional | 50 · Both sides | $1,621.81 | $1,905.46 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $251.19 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $218.78 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $218.78 |
CareFirst Setting Professional Modifier None Typical Low $12,589.25 Median $18,197.01 Typical High $22,387.21 | Professional | None | $12,589.25 | $18,197.01 | $22,387.21 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,912.51 Typical High $17,782.79 | Facility | None | $512.86 | $8,912.51 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,659.59 | Professional | None | $977.24 | $1,122.02 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,230.27 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,380.38 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $776.25 | $1,288.25 | $2,041.74 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $10,715.19 | Facility | None | $933.25 | $2,454.71 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,258.93 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $26,915.35 | Facility | None | $2,570.40 | $10,000.00 | $26,915.35 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $2,290.87 | Professional | None | $707.95 | $1,023.29 | $2,290.87 |
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 $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $851.14 |
Where Virginia sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 44th of 51
$1,259
AK $4,467HI $95.50
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.