How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,000 to $21,380Professionalmedian $1,096 · 10th to 90th $851 to $1,479
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 $1,096.48 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,096.48 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,096.48 | $1,096.48 |
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 $912.01 Median $1,096.48 Typical High $1,318.26 | Professional | None | $912.01 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,621.81 Typical High $1,949.84 | Professional | 50 · Both sides | $1,348.96 | $1,621.81 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $831.76 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $208.93 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $151.36 Typical High $181.97 | Professional | AS · PA/NP assist | $125.89 | $151.36 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Professional | None | $977.24 | $1,096.48 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,862.09 Typical High $3,162.28 | Facility | None | $512.86 | $1,862.09 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,513.56 | Professional | None | $831.76 | $977.24 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,288.25 | Professional | None | $851.14 | $1,023.29 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,778.28 | Facility | None | $1,096.48 | $1,202.26 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,445.44 | $2,041.74 |
Sentara Setting Facility Modifier None Typical Low $831.76 Median $2,454.71 Typical High $18,620.87 | Facility | None | $831.76 | $2,454.71 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $2,290.87 | Professional | None | $954.99 | $1,148.15 | $2,290.87 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,182.57 Typical High $33,113.11 | Facility | None | $4,570.88 | $13,182.57 | $33,113.11 |
United Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,737.80 | Professional | None | $676.08 | $870.96 | $1,737.80 |
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 $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $758.58 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $758.58 |
Where Virginia sits
The same service costs 14.1 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· 36th of 51
$1,096
AK $3,890TX $275
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.