How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $10,233Professionalmedian $2,399 · 10th to 90th $1,905 to $3,631
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 $2,511.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,511.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,235.94 | Professional | None | $2,344.23 | $2,344.23 | $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 $1,905.46 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,238.72 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | 80 · Assistant surgeon | $302.00 | $363.08 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $316.23 Typical High $398.11 | Professional | AS · PA/NP assist | $263.03 | $316.23 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,398.83 | $2,951.21 |
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 $1,905.46 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,570.40 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,187.76 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,884.03 | $3,548.13 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $3,801.89 | Facility | None | $2,344.23 | $3,019.95 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Sentara Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $7,762.47 | Facility | None | $1,380.38 | $2,398.83 | $7,762.47 |
Sentara Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $5,623.41 | Professional | None | $1,949.84 | $2,754.23 | $5,623.41 |
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 $1,862.09 Median $2,818.38 Typical High $4,466.84 | Professional | None | $1,862.09 | $2,818.38 | $4,466.84 |
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 $1,174.90 Median $1,174.90 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 53 · Discontinued | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,778.28 |
Where Virginia sits
The same service costs 5.2 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
$2,399
AK $8,128TX $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.