How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,259 to $20,417Professionalmedian $2,951 · 10th to 90th $2,455 to $3,715
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 $3,235.94 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,235.94 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,235.94 | Professional | None | $3,090.30 | $3,090.30 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $12,589.25 Typical High $23,988.33 | Facility | None | $5,248.07 | $12,589.25 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,570.40 | $2,951.21 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,862.09 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,621.81 | $1,862.09 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $478.63 Typical High $575.44 | Professional | 80 · Assistant surgeon | $407.38 | $478.63 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $416.87 Typical High $501.19 | Professional | AS · PA/NP assist | $354.81 | $416.87 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,467.37 | Professional | None | $2,691.53 | $2,951.21 | $3,467.37 |
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 $2,454.71 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,454.71 | $2,884.03 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $4,570.88 | Professional | None | $2,344.23 | $2,691.53 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $3,890.45 | Professional | None | $2,691.53 | $3,890.45 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $5,128.61 | Facility | None | $3,090.30 | $3,630.78 | $5,128.61 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,630.27 | $2,754.23 | $3,467.37 |
Sentara Setting Facility Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $10,232.93 | Facility | None | $1,659.59 | $2,884.03 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $4,365.16 | Professional | None | $2,041.74 | $3,019.95 | $4,365.16 |
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 $2,137.96 Median $2,630.27 Typical High $4,677.35 | Professional | None | $2,137.96 | $2,630.27 | $4,677.35 |
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 $1,548.82 Median $1,548.82 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | 53 · Discontinued | $630.96 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $2,290.87 |
Where Virginia sits
The same service costs 22.9 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· 32nd of 51
$2,951
AK $9,120TX $398
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.