How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,096 to $15,488Professionalmedian $1,175 · 10th to 90th $933 to $1,995
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 $1,258.93 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,258.93 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,202.26 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,412.54 | Professional | None | $933.25 | $1,122.02 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,659.59 Typical High $2,137.96 | Professional | 50 · Both sides | $1,412.54 | $1,659.59 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $707.95 Typical High $891.25 | Professional | 62 · Two surgeons | $588.84 | $707.95 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $223.87 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $199.53 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $6,918.31 | Professional | None | $1,000.00 | $1,122.02 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $6,025.60 | Facility | None | $512.86 | $3,090.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,862.09 | Professional | None | $933.25 | $1,348.96 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,318.26 | Professional | None | $870.96 | $1,047.13 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,148.15 | $1,548.82 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $10,715.19 | Facility | None | $933.25 | $2,454.71 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $10,232.93 | Professional | None | $1,047.13 | $1,513.56 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $2,290.87 | Professional | None | $933.25 | $1,584.89 | $2,290.87 |
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 $575.44 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $870.96 |
Where Virginia sits
The same service costs 5.1 times more in Wisconsin 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· 44th of 51
$1,259
WI $4,677TX $912
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.