How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $10,233Professionalmedian $2,512 · 10th to 90th $1,995 to $3,802
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 $2,691.53 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,691.53 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,570.40 | $3,467.37 |
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 $1,995.26 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,995.26 | $2,398.83 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,513.56 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,258.93 | $1,513.56 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | 80 · Assistant surgeon | $316.23 | $380.19 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $331.13 Typical High $426.58 | Professional | AS · PA/NP assist | $281.84 | $331.13 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,238.72 | $2,511.89 | $3,162.28 |
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 $1,995.26 Median $2,630.27 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,630.27 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,905.46 | $2,290.87 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,754.23 | $3,548.13 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $4,073.80 | Facility | None | $2,454.71 | $3,090.30 | $4,073.80 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Sentara Setting Facility Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $8,128.31 | Facility | None | $1,380.38 | $2,454.71 | $8,128.31 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $5,754.40 | Professional | None | $1,862.09 | $2,884.03 | $5,754.40 |
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 $1,905.46 Median $2,951.21 Typical High $4,466.84 | Professional | None | $1,905.46 | $2,951.21 | $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 $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 53 · Discontinued | $489.78 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $398.11 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,862.09 |
Where Virginia sits
The same service costs 6.6 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
$2,512
AK $8,710TX $1,318
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.