How much rates vary
Facilitymedian $4,074 · 10th to 90th $933 to $11,220Professionalmedian $1,413 · 10th to 90th $1,122 to $2,188
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 $1,479.11 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,479.11 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,479.11 | $2,754.23 |
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 $1,122.02 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,995.26 Typical High $2,511.89 | Professional | 50 · Both sides | $1,659.59 | $1,995.26 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $1,071.52 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $269.15 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $234.42 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,445.44 | $1,778.28 |
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 $1,122.02 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,445.44 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,258.93 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,659.59 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,238.72 | Facility | None | $1,380.38 | $1,737.80 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $1,862.09 Typical High $7,413.10 | Facility | None | $912.01 | $1,862.09 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $5,128.61 | Professional | None | $1,122.02 | $1,621.81 | $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 $1,071.52 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,621.81 | $2,511.89 |
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 $691.83 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $691.83 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,047.13 |
Where Virginia sits
The same service costs 5.2 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· 35th of 51
$1,514
AK $4,786TX $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.