How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,096 to $20,417Professionalmedian $1,413 · 10th to 90th $1,175 to $1,778
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 $1,513.56 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,513.56 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,513.56 | Professional | None | $1,479.11 | $1,479.11 | $1,513.56 |
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 $1,230.27 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,445.44 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $891.25 Typical High $1,096.48 | Professional | 62 · Two surgeons | $776.25 | $891.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $275.42 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $239.88 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,412.54 | $1,621.81 |
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 $1,230.27 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,348.96 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,412.54 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,454.71 | Facility | None | $1,479.11 | $1,778.28 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,318.26 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $7,413.10 | Facility | None | $1,047.13 | $1,905.46 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,479.11 | $2,089.30 |
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 $1,023.29 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,230.27 | $2,137.96 |
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 $741.31 Median $741.31 Typical High $758.58 | Professional | 52 · Reduced service | $741.31 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $302.00 | Professional | 53 · Discontinued | $295.12 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,071.52 |
Where Virginia sits
The same service costs 21.4 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· 33rd of 51
$1,413
AK $4,571TX $214
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.