How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $11,220Professionalmedian $1,995 · 10th to 90th $1,585 to $3,020
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 $2,137.96 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,137.96 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,041.74 | $2,884.03 |
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 $1,584.89 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,905.46 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,818.38 Typical High $3,548.13 | Professional | 50 · Both sides | $2,398.83 | $2,818.38 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $302.00 Typical High $380.19 | Professional | 80 · Assistant surgeon | $251.19 | $302.00 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $263.03 Typical High $331.13 | Professional | AS · PA/NP assist | $223.87 | $263.03 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,862.09 | $2,344.23 |
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 $1,584.89 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,089.30 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,862.09 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,344.23 | $3,019.95 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,235.94 | Facility | None | $1,949.84 | $2,398.83 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $8,912.51 | Facility | None | $1,288.25 | $2,137.96 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $5,495.41 | Professional | None | $1,513.56 | $2,238.72 | $5,495.41 |
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 $1,513.56 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,513.56 | $2,398.83 | $3,715.35 |
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 $977.24 Median $977.24 Typical High $1,071.52 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $426.58 | Professional | 53 · Discontinued | $398.11 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,479.11 |
Where Virginia sits
The same service costs 5.8 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· 33rd of 51
$2,138
AK $6,918TX $1,202
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.