How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,122 to $25,704Professionalmedian $1,698 · 10th to 90th $1,349 to $2,570
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 $1,778.28 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,778.28 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $16,595.87 Typical High $30,199.52 | Facility | None | $6,760.83 | $16,595.87 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,584.89 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $257.04 Typical High $323.59 | Professional | 80 · Assistant surgeon | $213.80 | $257.04 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $281.84 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,698.24 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,737.80 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,584.89 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,344.23 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,691.53 | Facility | None | $1,621.81 | $2,041.74 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $8,709.64 | Facility | None | $1,202.26 | $1,995.26 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $5,495.41 | Professional | None | $1,288.25 | $1,949.84 | $5,495.41 |
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 $1,288.25 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,995.26 | $3,090.30 |
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 $812.83 Median $812.83 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,258.93 |
Where Virginia sits
The same service costs 5.5 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
$1,820
AK $5,754TX $1,047
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.