How much rates vary
Facilitymedian $2,291 · 10th to 90th $537 to $10,000Professionalmedian $1,549 · 10th to 90th $1,230 to $2,291
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 $1,659.59 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,659.59 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $17,378.01 | Facility | None | $8,912.51 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,445.44 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,148.15 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $295.12 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,445.44 | $1,819.70 |
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 $1,230.27 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,621.81 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,445.44 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,778.28 | $2,238.72 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,479.11 | $1,819.70 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $5,888.44 | Facility | None | $1,023.29 | $1,819.70 | $5,888.44 |
Sentara Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $5,128.61 | Professional | None | $1,230.27 | $1,819.70 | $5,128.61 |
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 $1,148.15 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,148.15 | $1,778.28 | $2,691.53 |
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 $741.31 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $295.12 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,148.15 |
Where Virginia sits
The same service costs 5.0 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· 35th of 51
$1,585
AK $5,248TX $1,047
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.