How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,259 to $20,417Professionalmedian $2,754 · 10th to 90th $2,239 to $4,074
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 $2,884.03 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,884.03 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,754.23 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $12,589.25 Typical High $23,988.33 | Facility | None | $5,248.07 | $12,589.25 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,238.72 | $2,691.53 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,698.24 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,412.54 | $1,698.24 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $426.58 Typical High $549.54 | Professional | 80 · Assistant surgeon | $363.08 | $426.58 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | AS · PA/NP assist | $316.23 | $380.19 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $3,630.78 | Professional | None | $2,454.71 | $2,754.23 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,495.41 | Facility | None | $501.19 | $1,174.90 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $4,168.69 | Professional | None | $2,344.23 | $2,691.53 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $3,019.95 | Professional | None | $2,041.74 | $2,454.71 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,691.53 | $3,388.44 | $3,388.44 |
Medcost Setting Facility Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $4,466.84 | Facility | None | $2,754.23 | $3,162.28 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Sentara Setting Facility Modifier None Typical Low $1,479.11 Median $2,570.40 Typical High $9,772.37 | Facility | None | $1,479.11 | $2,570.40 | $9,772.37 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $5,754.40 | Professional | None | $2,187.76 | $2,951.21 | $5,754.40 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $3,019.95 Typical High $4,677.35 | Professional | None | $1,995.26 | $3,019.95 | $4,677.35 |
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 $1,318.26 Median $1,380.38 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $549.54 Typical High $575.44 | Professional | 53 · Discontinued | $524.81 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,041.74 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $2,041.74 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $416.87 Typical High $436.52 | Professional | 55 · Aftercare only | $398.11 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $275.42 Typical High $288.40 | Professional | 56 · Pre-op care only | $263.03 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,905.46 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,905.46 | $2,041.74 |
Where Virginia sits
The same service costs 11.0 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· 28th of 51
$2,818
AK $9,772TX $891
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.