How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,148 to $13,490Professionalmedian $1,349 · 10th to 90th $1,072 to $2,138
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 $1,445.44 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,445.44 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $4,365.16 | Professional | None | $1,258.93 | $1,318.26 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,318.26 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,995.26 Typical High $2,511.89 | Professional | 50 · Both sides | $1,659.59 | $1,995.26 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $831.76 Typical High $1,071.52 | Professional | 62 · Two surgeons | $691.83 | $831.76 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $269.15 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $234.42 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $10,715.19 | Professional | None | $1,096.48 | $1,230.27 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $5,754.40 | Facility | None | $645.65 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,380.38 | $2,041.74 |
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 $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,819.70 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,041.74 | Facility | None | $1,258.93 | $1,584.89 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,570.40 Typical High $10,232.93 | Facility | None | $933.25 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $7,413.10 | Professional | None | $1,047.13 | $1,621.81 | $7,413.10 |
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 $933.25 Median $1,513.56 Typical High $2,398.83 | Professional | None | $933.25 | $1,513.56 | $2,398.83 |
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 $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,000.00 |
Where Virginia sits
The same service costs 6.8 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· 41st of 51
$1,413
AK $4,786TX $708
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.