How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $10,965Professionalmedian $1,230 · 10th to 90th $1,000 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 $1,288.25 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,288.25 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,288.25 | $1,819.70 |
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 $1,047.13 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,258.93 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,290.87 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | 62 · Two surgeons | $660.69 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $213.80 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,122.02 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,235.94 | Facility | None | $645.65 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,737.80 | Professional | None | $954.99 | $1,148.15 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,230.27 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,905.46 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,089.30 | Facility | None | $1,288.25 | $1,445.44 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,737.80 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $10,232.93 | Facility | None | $933.25 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,380.38 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,089.30 | Professional | None | $812.83 | $1,071.52 | $2,089.30 |
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 $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $912.01 |
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· 37th of 51
$1,288
AK $4,571TX $575
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.