How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,259 to $20,417Professionalmedian $3,020 · 10th to 90th $2,399 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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $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 $3,090.30 Typical High $3,715.35 | Professional | None | $2,570.40 | $3,090.30 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,949.84 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,621.81 | $1,949.84 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $489.78 Typical High $588.84 | Professional | 80 · Assistant surgeon | $416.87 | $489.78 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $426.58 Typical High $524.81 | Professional | AS · PA/NP assist | $363.08 | $426.58 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $2,754.23 Median $3,019.95 Typical High $3,467.37 | Professional | None | $2,754.23 | $3,019.95 | $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 $4,168.69 | Professional | None | $2,454.71 | $2,884.03 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,677.35 | Professional | None | $2,570.40 | $2,951.21 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $3,388.44 Typical High $3,548.13 | Professional | None | $2,398.83 | $3,388.44 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $5,248.07 | Facility | None | $3,235.94 | $3,801.89 | $5,248.07 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $3,630.78 | Professional | None | $2,290.87 | $2,630.27 | $3,630.78 |
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 $1,737.80 Median $3,090.30 Typical High $4,466.84 | Professional | None | $1,737.80 | $3,090.30 | $4,466.84 |
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 $1,949.84 Median $2,511.89 Typical High $4,677.35 | Professional | None | $1,949.84 | $2,511.89 | $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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,290.87 |
Where Virginia sits
The same service costs 5.1 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
$3,020
AK $9,772TX $1,905
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.