How much rates vary
Facilitymedian $2,818 · 10th to 90th $537 to $10,233Professionalmedian $2,754 · 10th to 90th $2,188 to $4,169
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 $2,884.03 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,884.03 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,801.89 | Professional | None | $2,570.40 | $2,818.38 | $3,801.89 |
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 $2,187.76 Median $2,570.40 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,570.40 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,621.81 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,380.38 | $1,621.81 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $524.81 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | AS · PA/NP assist | $302.00 | $363.08 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,754.23 | $3,388.44 |
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 $2,187.76 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,187.76 | $2,951.21 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,511.89 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $3,311.31 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,311.31 | $4,168.69 | $4,168.69 |
Medcost Setting Facility Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,365.16 | Facility | None | $2,570.40 | $3,311.31 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Sentara Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $8,912.51 | Facility | None | $1,513.56 | $2,630.27 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $6,165.95 | Professional | None | $2,187.76 | $3,162.28 | $6,165.95 |
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 $2,089.30 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,089.30 | $3,311.31 | $4,897.79 |
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 $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $524.81 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $2,041.74 |
Where Virginia sits
The same service costs 5.8 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
$2,754
AK $9,333TX $1,622
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.