How much rates vary
Facilitymedian $2,399 · 10th to 90th $550 to $10,233Professionalmedian $1,778 · 10th to 90th $1,413 to $2,754
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 $1,905.46 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,905.46 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $3,715.35 | Professional | None | $1,698.24 | $1,862.09 | $3,715.35 |
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 $1,412.54 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,698.24 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $1,348.96 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $295.12 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,778.28 | $2,238.72 |
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 $1,445.44 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,862.09 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,659.59 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,570.40 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,818.38 | Facility | None | $1,698.24 | $2,041.74 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $6,918.31 | Facility | None | $1,230.27 | $2,089.30 | $6,918.31 |
Sentara Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,445.44 | $2,041.74 | $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 $1,348.96 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,348.96 | $2,089.30 | $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 $851.14 Median $851.14 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,318.26 |
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· 36th of 51
$1,820
AK $6,026TX $1,072
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.