How much rates vary
Facilitymedian $4,074 · 10th to 90th $912 to $11,220Professionalmedian $1,148 · 10th to 90th $912 to $1,778
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 $1,230.27 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,230.27 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,174.90 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $7,413.10 Typical High $12,589.25 | Facility | None | $2,818.38 | $7,413.10 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,380.38 | Professional | None | $912.01 | $1,096.48 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,659.59 Typical High $2,089.30 | Professional | 50 · Both sides | $1,380.38 | $1,659.59 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $218.78 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $190.55 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,122.02 | $1,380.38 |
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 $933.25 Median $1,174.90 Typical High $1,698.24 | Professional | None | $933.25 | $1,174.90 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,348.96 | Professional | None | $912.01 | $1,096.48 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,621.81 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,819.70 | Facility | None | $1,122.02 | $1,380.38 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $1,737.80 Typical High $7,413.10 | Facility | None | $912.01 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $4,570.88 | Professional | None | $933.25 | $1,318.26 | $4,570.88 |
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 $870.96 Median $1,348.96 Typical High $2,089.30 | Professional | None | $870.96 | $1,348.96 | $2,089.30 |
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 $562.34 Median $562.34 Typical High $616.60 | Professional | 52 · Reduced service | $562.34 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $870.96 |
Where Virginia sits
The same service costs 4.7 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· 34th of 51
$1,259
AK $3,981TX $851
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.