How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,549 to $21,878Professionalmedian $1,778 · 10th to 90th $1,445 to $2,512
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 $1,778.28 Median $7,244.36 Typical High $14,125.38 | Facility | None | $1,778.28 | $7,244.36 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,659.59 | $1,778.28 | $2,041.74 |
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 $1,513.56 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,778.28 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,691.53 Typical High $3,235.94 | Professional | 50 · Both sides | $2,238.72 | $2,691.53 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | 62 · Two surgeons | $954.99 | $1,122.02 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $346.74 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $302.00 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,862.09 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,912.51 Typical High $17,782.79 | Facility | None | $512.86 | $8,912.51 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,621.81 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,659.59 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,137.96 | $2,754.23 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,951.21 | Facility | None | $1,778.28 | $2,089.30 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,778.28 | $1,949.84 | $3,090.30 |
Sentara Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $18,620.87 | Facility | None | $1,230.27 | $3,235.94 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $3,890.45 | Professional | None | $1,513.56 | $1,862.09 | $3,890.45 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,951.21 | Professional | None | $1,122.02 | $1,445.44 | $2,951.21 |
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 $831.76 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $831.76 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,258.93 |
Where Virginia sits
The same service costs 20.0 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
$1,778
AK $6,457TX $324
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.