How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,230 to $13,804Professionalmedian $1,349 · 10th to 90th $1,072 to $1,862
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 $1,348.96 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,348.96 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,348.96 | $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 $1,122.02 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,318.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,995.26 Typical High $2,398.83 | Professional | 50 · Both sides | $1,659.59 | $1,995.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $257.04 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $223.87 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,230.27 | $1,380.38 | $1,621.81 |
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 $1,122.02 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,202.26 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,230.27 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,737.80 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,187.76 | Facility | None | $1,348.96 | $1,621.81 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,819.70 | $1,819.70 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $10,715.19 | Facility | None | $933.25 | $2,754.23 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,513.56 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $2,187.76 | Professional | None | $831.76 | $1,122.02 | $2,187.76 |
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 $616.60 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $616.60 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $933.25 |
Where Virginia sits
The same service costs 8.7 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
$1,349
AK $4,786TX $550
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.