How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,259 to $25,119Professionalmedian $1,413 · 10th to 90th $1,122 to $1,950
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 $1,412.54 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,412.54 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $21,877.62 Median $28,183.83 Typical High $30,199.52 | Facility | None | $21,877.62 | $28,183.83 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,137.96 Typical High $2,570.40 | Professional | 50 · Both sides | $1,778.28 | $2,137.96 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,071.52 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,412.54 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $18,197.01 | Facility | None | $645.65 | $3,311.31 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,288.25 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,348.96 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,949.84 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,290.87 | Facility | None | $1,412.54 | $1,621.81 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $3,548.13 | Professional | None | $1,445.44 | $1,513.56 | $3,548.13 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,818.38 Typical High $12,882.50 | Facility | None | $1,023.29 | $2,818.38 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,479.11 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,964.78 Typical High $28,183.83 | Facility | None | $2,630.27 | $10,964.78 | $28,183.83 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,290.87 | Professional | None | $870.96 | $1,122.02 | $2,290.87 |
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 $660.69 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $977.24 |
Where Virginia sits
The same service costs 7.6 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· 35th of 51
$1,413
AK $5,129TX $676
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.