How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,445 to $15,488Professionalmedian $1,660 · 10th to 90th $1,318 to $2,291
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 $1,659.59 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,659.59 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,659.59 | $2,238.72 |
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 $1,380.38 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,659.59 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,454.71 Typical High $2,951.21 | Professional | 50 · Both sides | $2,041.74 | $2,454.71 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,023.29 Typical High $1,258.93 | Professional | 62 · Two surgeons | $870.96 | $1,023.29 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $316.23 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | AS · PA/NP assist | $190.55 | $229.09 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,698.24 | $1,995.26 |
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 $1,380.38 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,479.11 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,513.56 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,949.84 | $2,398.83 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,659.59 | $1,949.84 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,819.70 | $2,089.30 | $3,090.30 |
Sentara Setting Facility Modifier None Typical Low $1,148.15 Median $2,884.03 Typical High $10,715.19 | Facility | None | $1,148.15 | $2,884.03 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,412.54 | $1,737.80 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,348.96 | $2,630.27 |
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 $758.58 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $758.58 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,148.15 |
Where Virginia sits
The same service costs 8.7 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· 38th of 51
$1,660
AK $5,888TX $676
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.