How much rates vary
Facilitymedian $2,570 · 10th to 90th $537 to $10,233Professionalmedian $2,291 · 10th to 90th $1,820 to $3,467
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 $2,137.96 Median $2,344.23 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,344.23 | $3,235.94 |
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 $1,819.70 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,819.70 | $2,137.96 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,348.96 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,148.15 | $1,348.96 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $346.74 Typical High $436.52 | Professional | 80 · Assistant surgeon | $288.40 | $346.74 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $302.00 Typical High $380.19 | Professional | AS · PA/NP assist | $251.19 | $302.00 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,290.87 | $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 $1,819.70 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,454.71 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,089.30 | $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 $2,137.96 Median $2,818.38 Typical High $3,630.78 | Facility | None | $2,137.96 | $2,818.38 | $3,630.78 |
Medcost Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $7,413.10 | Facility | None | $1,288.25 | $2,290.87 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,630.27 Typical High $5,495.41 | Professional | None | $1,862.09 | $2,630.27 | $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 $1,737.80 Median $2,818.38 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,818.38 | $4,073.80 |
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 $1,071.52 Median $1,071.52 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 53 · Discontinued | $426.58 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $245.47 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,698.24 |
Where Virginia sits
The same service costs 6.0 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· 37th of 51
$2,291
AK $7,762TX $1,288
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.