How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,622 to $25,119Professionalmedian $1,820 · 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 $1,819.70 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,819.70 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,698.24 | $1,819.70 | $1,819.70 |
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 $1,819.70 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,148.15 Typical High $1,380.38 | Professional | 62 · Two surgeons | $954.99 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $288.40 Typical High $346.74 | Professional | 80 · Assistant surgeon | $245.47 | $288.40 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | AS · PA/NP assist | $213.80 | $257.04 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,659.59 | $1,819.70 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,709.64 Typical High $17,378.01 | Facility | None | $512.86 | $8,709.64 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,621.81 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,698.24 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,630.27 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,019.95 | Facility | None | $1,819.70 | $2,089.30 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,949.84 | $2,344.23 | $4,786.30 |
Sentara Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $18,620.87 | Facility | None | $1,258.93 | $3,235.94 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,890.45 | Professional | None | $1,479.11 | $1,905.46 | $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 $1,148.15 Median $1,445.44 Typical High $2,951.21 | Professional | None | $1,148.15 | $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 $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,258.93 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,288.25 | $1,288.25 |
Where Virginia sits
The same service costs 20.4 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· 35th of 51
$1,820
AK $6,607TX $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.