How much rates vary
Facilitymedian $2,344 · 10th to 90th $537 to $10,000Professionalmedian $1,778 · 10th to 90th $1,413 to $2,754
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 $1,905.46 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,905.46 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,737.80 | $1,819.70 | $2,570.40 |
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 $1,412.54 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,698.24 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $1,348.96 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $302.00 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,548.82 | $1,698.24 | $2,137.96 |
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 $1,412.54 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,949.84 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,621.81 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,818.38 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,818.38 | Facility | None | $1,737.80 | $2,187.76 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $6,918.31 | Facility | None | $1,096.48 | $2,137.96 | $6,918.31 |
Sentara Setting Professional Modifier None Typical Low $1,513.56 Median $2,137.96 Typical High $5,495.41 | Professional | None | $1,513.56 | $2,137.96 | $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 $1,348.96 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,348.96 | $2,187.76 | $3,162.28 |
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 $870.96 Median $870.96 Typical High $954.99 | Professional | 52 · Reduced service | $870.96 | $870.96 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 53 · Discontinued | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,318.26 |
Where Virginia sits
The same service costs 5.9 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
$1,820
AK $6,166TX $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.