How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,445 to $15,488Professionalmedian $1,549 · 10th to 90th $1,259 to $2,188
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 $1,548.82 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,548.82 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,548.82 | $1,778.28 |
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 $1,318.26 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $302.00 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $218.78 Typical High $263.03 | Professional | AS · PA/NP assist | $181.97 | $218.78 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,621.81 | $1,905.46 |
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 $1,318.26 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,412.54 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,445.44 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,778.28 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,570.40 | Facility | None | $1,548.82 | $1,819.70 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $4,168.69 | Professional | None | $1,698.24 | $2,041.74 | $4,168.69 |
Sentara Setting Facility Modifier None Typical Low $1,096.48 Median $2,818.38 Typical High $10,715.19 | Facility | None | $1,096.48 | $2,818.38 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $3,388.44 | Professional | None | $1,318.26 | $1,659.59 | $3,388.44 |
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 $954.99 Median $1,258.93 Typical High $2,570.40 | Professional | None | $954.99 | $1,258.93 | $2,570.40 |
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 $724.44 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $724.44 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $288.40 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,096.48 |
Where Virginia sits
The same service costs 18.6 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· 36th of 51
$1,585
AK $5,623TX $302
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.