How much rates vary
Facilitymedian $2,188 · 10th to 90th $537 to $10,000Professionalmedian $1,349 · 10th to 90th $1,072 to $2,089
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 $1,445.44 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,445.44 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,380.38 | $1,905.46 |
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 $1,071.52 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $223.87 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,348.96 | $1,698.24 |
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 $1,071.52 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,513.56 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,230.27 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,698.24 | $2,137.96 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,137.96 | Facility | None | $1,288.25 | $1,584.89 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $5,495.41 | Facility | None | $933.25 | $1,737.80 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $5,128.61 | Professional | None | $1,148.15 | $1,659.59 | $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 $1,023.29 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,659.59 | $2,398.83 |
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 $645.65 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,000.00 |
Where Virginia sits
The same service costs 5.6 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· 37th of 51
$1,380
AK $4,571TX $813
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.