How much rates vary
Facilitymedian $2,291 · 10th to 90th $537 to $10,000Professionalmedian $1,660 · 10th to 90th $1,318 to $2,512
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 $1,698.24 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,698.24 | $2,398.83 |
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 $1,318.26 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,548.82 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $977.24 Typical High $1,230.27 | Professional | 62 · Two surgeons | $831.76 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $316.23 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $218.78 Typical High $275.42 | Professional | AS · PA/NP assist | $181.97 | $218.78 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,659.59 | $2,089.30 |
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 $1,318.26 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,737.80 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,548.82 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,778.28 | $2,238.72 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,630.27 | Facility | None | $1,621.81 | $1,949.84 | $2,630.27 |
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 $1,862.09 Typical High $6,456.54 | Facility | None | $1,023.29 | $1,862.09 | $6,456.54 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $5,370.32 | Professional | None | $1,288.25 | $1,862.09 | $5,370.32 |
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 $1,258.93 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,905.46 | $2,951.21 |
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 $870.96 | Professional | 52 · Reduced service | $812.83 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $354.81 | Professional | 53 · Discontinued | $323.59 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $263.03 |
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 $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,230.27 |
Where Virginia sits
The same service costs 5.6 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· 35th of 51
$1,698
AK $5,623TX $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.