How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,660 to $15,488Professionalmedian $1,905 · 10th to 90th $1,549 to $2,692
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 $1,905.46 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,905.46 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,778.28 | $1,905.46 | $3,388.44 |
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 $1,584.89 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,905.46 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,884.03 Typical High $3,467.37 | Professional | 50 · Both sides | $2,398.83 | $2,884.03 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $1,445.44 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $363.08 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $323.59 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,949.84 | $2,290.87 |
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 $1,621.81 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,621.81 | $1,698.24 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,778.28 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,884.03 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $3,162.28 | Facility | None | $1,905.46 | $2,290.87 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,398.83 | $3,548.13 |
Sentara Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $10,715.19 | Facility | None | $1,318.26 | $3,388.44 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,659.59 | $2,041.74 | $3,981.07 |
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 $1,202.26 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,584.89 | $3,090.30 |
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 $870.96 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $870.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,348.96 | $1,348.96 |
Where Virginia sits
The same service costs 9.3 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
$1,905
AK $6,918TX $741
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.