How much rates vary
Facilitymedian $2,291 · 10th to 90th $537 to $10,233Professionalmedian $1,445 · 10th to 90th $1,148 to $2,239
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 $1,548.82 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,548.82 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,513.56 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,380.38 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,096.48 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $218.78 Typical High $275.42 | Professional | 80 · Assistant surgeon | $181.97 | $218.78 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $239.88 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,445.44 | $1,819.70 |
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 $1,174.90 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,584.89 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,348.96 | $1,659.59 |
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 $1,412.54 Median $1,659.59 Typical High $2,290.87 | Facility | None | $1,412.54 | $1,659.59 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $5,623.41 | Facility | None | $1,023.29 | $1,819.70 | $5,623.41 |
Sentara Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $5,128.61 | Professional | None | $1,202.26 | $1,737.80 | $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 $1,096.48 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,698.24 | $2,570.40 |
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 $707.95 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,071.52 |
Where Virginia sits
The same service costs 5.4 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· 36th of 51
$1,479
AK $5,012TX $933
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.