How much rates vary
Facilitymedian $2,239 · 10th to 90th $537 to $10,000Professionalmedian $1,380 · 10th to 90th $1,096 to $2,138
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 $1,479.11 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,479.11 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,412.54 | $1,995.26 |
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 $1,096.48 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,318.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $812.83 Typical High $1,047.13 | Professional | 62 · Two surgeons | $691.83 | $812.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $229.09 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,318.26 | $1,659.59 |
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 $1,122.02 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,513.56 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,698.24 | $2,137.96 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,187.76 | Facility | None | $1,318.26 | $1,659.59 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $977.24 Median $1,778.28 Typical High $5,495.41 | Facility | None | $977.24 | $1,778.28 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $5,128.61 | Professional | None | $1,174.90 | $1,698.24 | $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 $1,047.13 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,698.24 | $2,511.89 |
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 $660.69 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,023.29 |
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· 37th of 51
$1,413
AK $4,677TX $851
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.