How much rates vary
Facilitymedian $6,166 · 10th to 90th $2,138 to $14,125Professionalmedian $4,169 · 10th to 90th $3,311 to $5,754
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 $3,801.89 Median $5,888.44 Typical High $14,125.38 | Facility | None | $3,801.89 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,981.07 | $4,265.80 | $4,265.80 |
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 $3,548.13 Median $4,265.80 Typical High $5,128.61 | Professional | None | $3,548.13 | $4,265.80 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $5,370.32 Median $6,456.54 Typical High $7,762.47 | Professional | 50 · Both sides | $5,370.32 | $6,456.54 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,238.72 Median $2,691.53 Typical High $3,235.94 | Professional | 62 · Two surgeons | $2,238.72 | $2,691.53 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $676.08 Typical High $812.83 | Professional | 80 · Assistant surgeon | $575.44 | $676.08 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $602.56 Typical High $724.44 | Professional | AS · PA/NP assist | $501.19 | $602.56 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $5,248.07 | Professional | None | $3,890.45 | $4,365.16 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,466.84 Typical High $8,912.51 | Facility | None | $512.86 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,801.89 Typical High $5,754.40 | Professional | None | $3,162.28 | $3,801.89 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $4,897.79 | Professional | None | $3,311.31 | $3,981.07 | $4,897.79 |
Medcost Setting Professional Modifier None Typical Low $5,248.07 Median $6,606.93 Typical High $6,606.93 | Professional | None | $5,248.07 | $6,606.93 | $6,606.93 |
Medcost Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $7,079.46 | Facility | None | $4,265.80 | $4,786.30 | $7,079.46 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $5,248.07 Typical High $6,025.60 | Professional | None | $4,265.80 | $5,248.07 | $6,025.60 |
Sentara Setting Facility Modifier None Typical Low $2,454.71 Median $4,365.16 Typical High $12,022.64 | Facility | None | $2,454.71 | $4,365.16 | $12,022.64 |
Sentara Setting Professional Modifier None Typical Low $3,311.31 Median $4,365.16 Typical High $8,912.51 | Professional | None | $3,311.31 | $4,365.16 | $8,912.51 |
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 $2,691.53 Median $3,467.37 Typical High $6,918.31 | Professional | None | $2,691.53 | $3,467.37 | $6,918.31 |
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 $1,995.26 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,995.26 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,951.21 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,754.23 | $3,019.95 | $3,019.95 |
Where Virginia sits
The same service costs 20.4 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
$4,266
AK $15,488TX $759
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.