How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,413 to $10,965Professionalmedian $1,738 · 10th to 90th $1,380 to $2,399
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 $1,737.80 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,737.80 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,737.80 | $2,398.83 |
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 $1,445.44 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,737.80 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $2,570.40 Typical High $3,162.28 | Professional | 50 · Both sides | $2,187.76 | $2,570.40 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $331.13 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $288.40 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,187.76 Typical High $3,981.07 | Facility | None | $512.86 | $2,187.76 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,548.82 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,621.81 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,570.40 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,884.03 | Facility | None | $1,737.80 | $2,041.74 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,187.76 | $2,454.71 |
Sentara Setting Facility Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $10,232.93 | Facility | None | $1,202.26 | $2,454.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,862.09 | $3,715.35 |
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 $1,071.52 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,412.54 | $2,818.38 |
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 $794.33 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $794.33 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,230.27 |
Where Virginia sits
The same service costs 16.2 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
$1,738
AK $6,310TX $389
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.