How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,230 to $13,183Professionalmedian $1,514 · 10th to 90th $1,122 to $2,291
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 $5,623.41 Typical High $11,481.54 | Facility | None | $1,548.82 | $5,623.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,548.82 | $1,905.46 |
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 $1,148.15 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $239.88 Typical High $316.23 | Professional | 80 · Assistant surgeon | $186.21 | $239.88 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $208.93 Typical High $281.84 | Professional | AS · PA/NP assist | $158.49 | $208.93 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $4,897.79 | Professional | None | $1,122.02 | $1,230.27 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,019.95 Typical High $5,754.40 | Facility | None | $724.44 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,513.56 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,905.46 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,698.24 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,511.89 | Facility | None | $1,230.27 | $1,548.82 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,570.40 Typical High $10,232.93 | Facility | None | $933.25 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $7,762.47 | Professional | None | $1,288.25 | $1,819.70 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,630.27 | Professional | None | $977.24 | $1,584.89 | $2,630.27 |
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 $616.60 Median $707.95 Typical High $912.01 | Professional | 52 · Reduced service | $616.60 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $288.40 Typical High $363.08 | Professional | 53 · Discontinued | $251.19 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $933.25 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $141.25 Typical High $181.97 | Professional | 56 · Pre-op care only | $123.03 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,000.00 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $870.96 | $1,000.00 | $1,258.93 |
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· 39th of 51
$1,549
AK $6,026TX $1,148
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.