How much rates vary
Facilitymedian $5,248 · 10th to 90th $891 to $19,953Professionalmedian $1,122 · 10th to 90th $912 to $1,660
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 $1,148.15 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,148.15 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $13,182.57 Typical High $23,442.29 | Facility | None | $5,248.07 | $13,182.57 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,412.54 | Professional | None | $912.01 | $1,096.48 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $891.25 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $223.87 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $194.98 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,122.02 | $1,479.11 |
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 $933.25 Median $1,122.02 Typical High $1,698.24 | Professional | None | $933.25 | $1,122.02 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,348.96 | Professional | None | $912.01 | $1,096.48 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,122.02 | $1,348.96 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $7,413.10 | Facility | None | $851.14 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,398.83 | Professional | None | $954.99 | $1,288.25 | $2,398.83 |
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 $812.83 Median $1,230.27 Typical High $1,905.46 | Professional | None | $812.83 | $1,230.27 | $1,905.46 |
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 $537.03 Median $562.34 Typical High $575.44 | Professional | 52 · Reduced service | $537.03 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $234.42 | Professional | 53 · Discontinued | $213.80 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $812.83 |
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· 34th of 51
$1,148
AK $3,981TX $589
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.