How much rates vary
Facilitymedian $2,291 · 10th to 90th $537 to $10,000Professionalmedian $1,585 · 10th to 90th $1,259 to $2,455
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 $1,698.24 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,698.24 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,548.82 | $1,659.59 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $17,378.01 | Facility | None | $8,912.51 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,513.56 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $954.99 Typical High $1,202.26 | Professional | 62 · Two surgeons | $794.33 | $954.99 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $302.00 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,584.89 | $1,995.26 |
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 $1,288.25 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,659.59 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,238.72 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,511.89 | Facility | None | $1,548.82 | $1,905.46 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $6,165.95 | Facility | None | $1,023.29 | $1,819.70 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $5,128.61 | Professional | None | $1,258.93 | $1,819.70 | $5,128.61 |
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 $1,202.26 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,862.09 | $2,818.38 |
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 $776.25 Median $776.25 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,174.90 |
Where Virginia sits
The same service costs 5.4 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· 37th of 51
$1,622
AK $5,370TX $1,000
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.