How much rates vary
Facilitymedian $3,020 · 10th to 90th $537 to $10,233Professionalmedian $3,090 · 10th to 90th $2,455 to $4,677
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 $3,235.94 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,235.94 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,235.94 Typical High $3,981.07 | Professional | None | $3,019.95 | $3,235.94 | $3,981.07 |
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 $2,454.71 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,454.71 | $2,951.21 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $467.74 Typical High $602.56 | Professional | 80 · Assistant surgeon | $398.11 | $467.74 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $416.87 Typical High $524.81 | Professional | AS · PA/NP assist | $346.74 | $416.87 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $3,890.45 | Professional | None | $2,818.38 | $3,090.30 | $3,890.45 |
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 $2,511.89 Median $3,311.31 Typical High $4,677.35 | Professional | None | $2,511.89 | $3,311.31 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,398.83 | $2,884.03 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,090.30 | $3,801.89 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $5,011.87 | Facility | None | $3,019.95 | $3,801.89 | $5,011.87 |
Medcost Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Sentara Setting Facility Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $10,232.93 | Facility | None | $1,698.24 | $2,818.38 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $2,089.30 Median $3,548.13 Typical High $7,079.46 | Professional | None | $2,089.30 | $3,548.13 | $7,079.46 |
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 $2,398.83 Median $3,630.78 Typical High $5,623.41 | Professional | None | $2,398.83 | $3,630.78 | $5,623.41 |
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 $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | 53 · Discontinued | $616.60 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $2,344.23 |
Where Virginia sits
The same service costs 6.9 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
$3,090
AK $10,715TX $1,549
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.