How much rates vary
Facilitymedian $2,630 · 10th to 90th $537 to $10,233Professionalmedian $2,291 · 10th to 90th $1,820 to $3,548
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 $2,454.71 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,454.71 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,398.83 | $3,235.94 |
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 $1,819.70 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,819.70 | $2,187.76 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,380.38 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,148.15 | $1,380.38 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $354.81 Typical High $446.68 | Professional | 80 · Assistant surgeon | $295.12 | $354.81 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $309.03 Typical High $389.05 | Professional | AS · PA/NP assist | $257.04 | $309.03 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,344.23 | $2,884.03 |
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 $1,862.09 Median $2,570.40 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,570.40 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,137.96 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,884.03 | $3,630.78 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $3,715.35 | Facility | None | $2,290.87 | $2,818.38 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $7,585.78 | Facility | None | $1,348.96 | $2,344.23 | $7,585.78 |
Sentara Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,691.53 | $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 $1,778.28 Median $2,818.38 Typical High $4,265.80 | Professional | None | $1,778.28 | $2,818.38 | $4,265.80 |
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 $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | 53 · Discontinued | $457.09 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,737.80 |
Where Virginia sits
The same service costs 5.8 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
$2,291
AK $7,943TX $1,380
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.