How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,288 to $13,490Professionalmedian $1,445 · 10th to 90th $1,175 to $2,291
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 $1,584.89 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,584.89 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $4,365.16 | Professional | None | $1,412.54 | $1,412.54 | $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 $1,202.26 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,445.44 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $1,174.90 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $295.12 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $5,623.41 | Professional | None | $1,288.25 | $1,412.54 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $5,754.40 | Facility | None | $724.44 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,348.96 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,290.87 | Facility | None | $1,412.54 | $1,548.82 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $7,413.10 | Professional | None | $1,174.90 | $1,548.82 | $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 $977.24 Median $1,584.89 Typical High $2,454.71 | Professional | None | $977.24 | $1,584.89 | $2,454.71 |
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 $707.95 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,096.48 |
Where Virginia sits
The same service costs 6.6 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· 38th of 51
$1,514
AK $5,248TX $794
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.