How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,259 to $20,417Professionalmedian $4,786 · 10th to 90th $3,715 to $5,888
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 $3,801.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,801.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $4,073.80 Median $4,786.30 Typical High $5,888.44 | Professional | None | $4,073.80 | $4,786.30 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $3,019.95 Typical High $3,715.35 | Professional | 62 · Two surgeons | $2,570.40 | $3,019.95 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $776.25 Typical High $933.25 | Professional | 80 · Assistant surgeon | $645.65 | $776.25 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $575.44 Median $676.08 Typical High $812.83 | Professional | AS · PA/NP assist | $575.44 | $676.08 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $5,495.41 | Professional | None | $4,265.80 | $4,786.30 | $5,495.41 |
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 $3,715.35 Median $4,570.88 Typical High $6,456.54 | Professional | None | $3,715.35 | $4,570.88 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $4,570.88 Typical High $7,585.78 | Professional | None | $3,981.07 | $4,570.88 | $7,585.78 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $5,888.44 Typical High $5,888.44 | Professional | None | $2,754.23 | $5,888.44 | $5,888.44 |
Medcost Setting Facility Modifier None Typical Low $5,128.61 Median $5,754.40 Typical High $8,317.64 | Facility | None | $5,128.61 | $5,754.40 | $8,317.64 |
Medcost Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $5,754.40 | Professional | None | $2,570.40 | $3,019.95 | $5,754.40 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $4,265.80 Typical High $10,232.93 | Facility | None | $1,737.80 | $4,265.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,995.26 Median $4,897.79 Typical High $7,079.46 | Professional | None | $1,995.26 | $4,897.79 | $7,079.46 |
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 $2,454.71 Median $3,981.07 Typical High $7,413.10 | Professional | None | $2,454.71 | $3,981.07 | $7,413.10 |
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 $2,511.89 Median $2,511.89 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,511.89 | $2,511.89 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,801.89 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $3,548.13 | $3,548.13 | $3,548.13 |
Where Virginia sits
The same service costs 21.9 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· 34th of 51
$4,786
AK $15,136TX $692
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.