How much rates vary
Facilitymedian $9,120 · 10th to 90th $1,738 to $22,387Professionalmedian $1,660 · 10th to 90th $1,349 to $2,042
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 $1,778.28 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,778.28 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,737.80 | $1,778.28 |
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 $1,412.54 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,659.59 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,047.13 Typical High $1,258.93 | Professional | 62 · Two surgeons | $891.25 | $1,047.13 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $323.59 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $281.84 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,737.80 | $1,995.26 |
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 $1,380.38 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,584.89 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,548.82 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,659.59 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,737.80 | $2,137.96 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,412.54 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $1,122.02 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,122.02 | $3,235.94 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,698.24 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,445.44 | $2,454.71 |
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 $870.96 Median $870.96 Typical High $891.25 | Professional | 52 · Reduced service | $870.96 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,230.27 |
Where Virginia sits
The same service costs 6.3 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
$1,698
AK $6,166TX $977
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.