How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,148 to $20,417Professionalmedian $1,549 · 10th to 90th $1,288 to $1,950
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 $1,659.59 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,659.59 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,659.59 | $1,659.59 |
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 $1,348.96 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,202.26 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $251.19 Typical High $302.00 | Professional | 80 · Assistant surgeon | $218.78 | $251.19 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $218.78 Typical High $269.15 | Professional | AS · PA/NP assist | $190.55 | $218.78 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,548.82 | $1,819.70 |
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 $1,318.26 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,513.56 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,548.82 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,187.76 | Professional | None | $1,659.59 | $2,137.96 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,691.53 | Facility | None | $1,621.81 | $1,949.84 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,479.11 | $1,862.09 |
Sentara Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $7,585.78 | Facility | None | $1,071.52 | $1,995.26 | $7,585.78 |
Sentara Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,621.81 | $2,290.87 |
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 $1,122.02 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,380.38 | $2,398.83 |
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 $812.83 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,174.90 |
Where Virginia sits
The same service costs 5.0 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
$1,585
AK $5,012TX $1,000
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.