How much rates vary
Facilitymedian $5,248 · 10th to 90th $955 to $20,417Professionalmedian $1,072 · 10th to 90th $912 to $1,380
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 $1,148.15 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,148.15 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,122.02 | $1,148.15 | $1,148.15 |
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 $933.25 Median $1,096.48 Typical High $1,318.26 | Professional | None | $933.25 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $831.76 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $177.83 Typical High $208.93 | Professional | 80 · Assistant surgeon | $147.91 | $177.83 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $186.21 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,230.27 | Professional | None | $977.24 | $1,071.52 | $1,230.27 |
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 $954.99 Median $1,047.13 Typical High $1,479.11 | Professional | None | $954.99 | $1,047.13 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,698.24 | Professional | None | $933.25 | $1,071.52 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,737.80 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,862.09 | Facility | None | $1,122.02 | $1,380.38 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,445.44 | $2,041.74 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $1,737.80 Typical High $7,413.10 | Facility | None | $912.01 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,122.02 | $1,659.59 |
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 $794.33 Median $977.24 Typical High $1,698.24 | Professional | None | $794.33 | $977.24 | $1,698.24 |
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 $562.34 Median $562.34 Typical High $575.44 | Professional | 52 · Reduced service | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $851.14 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $812.83 |
Where Virginia sits
The same service costs 24.5 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
$1,096
AK $4,074TX $166
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.