How much rates vary
Facilitymedian $2,512 · 10th to 90th $537 to $10,233Professionalmedian $2,042 · 10th to 90th $1,622 to $3,162
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 $2,187.76 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,187.76 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,995.26 | $2,089.30 | $2,951.21 |
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 $1,621.81 Median $1,949.84 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,949.84 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,230.27 Typical High $1,548.82 | Professional | 62 · Two surgeons | $1,023.29 | $1,230.27 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $316.23 Typical High $398.11 | Professional | 80 · Assistant surgeon | $263.03 | $316.23 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $275.42 Typical High $346.74 | Professional | AS · PA/NP assist | $229.09 | $275.42 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,089.30 | $2,570.40 |
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 $1,659.59 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,659.59 | $2,290.87 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,905.46 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,570.40 | $3,235.94 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,311.31 | Facility | None | $1,995.26 | $2,511.89 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $7,413.10 | Facility | None | $1,288.25 | $2,187.76 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $5,495.41 | Professional | None | $1,737.80 | $2,398.83 | $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 $1,548.82 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,548.82 | $2,511.89 | $3,801.89 |
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 $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 53 · Discontinued | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,548.82 |
Where Virginia sits
The same service costs 5.9 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· 38th of 51
$2,089
AK $7,079TX $1,202
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.