How much rates vary
Facilitymedian $3,236 · 10th to 90th $537 to $10,233Professionalmedian $3,715 · 10th to 90th $2,951 to $5,623
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 $3,630.78 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,630.78 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,630.78 Typical High $4,365.16 | Professional | None | $3,548.13 | $3,630.78 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $3,548.13 Typical High $4,466.84 | Professional | None | $2,951.21 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,238.72 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,862.09 | $2,238.72 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $562.34 Typical High $707.95 | Professional | 80 · Assistant surgeon | $467.74 | $562.34 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $489.78 Typical High $616.60 | Professional | AS · PA/NP assist | $407.38 | $489.78 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $4,677.35 | Professional | None | $3,311.31 | $3,715.35 | $4,677.35 |
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 $2,951.21 Median $3,801.89 Typical High $5,623.41 | Professional | None | $2,951.21 | $3,801.89 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,884.03 Median $3,467.37 Typical High $4,265.80 | Professional | None | $2,884.03 | $3,467.37 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $3,630.78 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,630.78 | $4,677.35 | $4,677.35 |
Medcost Setting Facility Modifier None Typical Low $3,630.78 Median $4,570.88 Typical High $6,025.60 | Facility | None | $3,630.78 | $4,570.88 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $3,235.94 Typical High $10,232.93 | Facility | None | $1,737.80 | $3,235.94 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $2,290.87 Median $4,168.69 Typical High $7,943.28 | Professional | None | $2,290.87 | $4,168.69 | $7,943.28 |
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 $2,818.38 Median $4,365.16 Typical High $6,760.83 | Professional | None | $2,818.38 | $4,365.16 | $6,760.83 |
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 $1,819.70 Median $1,819.70 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 53 · Discontinued | $724.44 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,754.23 |
Where Virginia sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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
$3,631
AK $12,589AR $1,995
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.