How much rates vary
Facilitymedian $2,455 · 10th to 90th $537 to $10,233Professionalmedian $2,042 · 10th to 90th $1,622 to $3,090
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 $1,995.26 Typical High $2,884.03 | Professional | None | $1,995.26 | $1,995.26 | $2,884.03 |
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 $257.04 Median $309.03 Typical High $389.05 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,041.74 | $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 $1,621.81 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,187.76 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,862.09 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,454.71 | $3,162.28 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,235.94 | Facility | None | $1,995.26 | $2,454.71 | $3,235.94 |
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 $1,258.93 Median $2,187.76 Typical High $7,413.10 | Facility | None | $1,258.93 | $2,187.76 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,344.23 | $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 $3,715.35 | Professional | None | $1,548.82 | $2,511.89 | $3,715.35 |
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 $977.24 Median $977.24 Typical High $1,071.52 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,071.52 |
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 $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $323.59 |
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 $1,380.38 Median $1,380.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,513.56 |
Where Virginia sits
The same service costs 5.5 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· 37th of 51
$2,042
AK $6,918TX $1,259
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.