How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,096 to $12,303Professionalmedian $2,042 · 10th to 90th $1,622 to $2,884
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 $2,454.71 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,454.71 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,398.83 Typical High $2,454.71 | Professional | None | $2,344.23 | $2,398.83 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $7,413.10 Typical High $14,125.38 | Facility | None | $3,162.28 | $7,413.10 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,905.46 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,202.26 Typical High $1,288.25 | Professional | 62 · Two surgeons | $1,023.29 | $1,202.26 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $302.00 Typical High $331.13 | Professional | 80 · Assistant surgeon | $257.04 | $302.00 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $263.03 Typical High $288.40 | Professional | AS · PA/NP assist | $223.87 | $263.03 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $2,754.23 | Professional | None | $2,137.96 | $2,398.83 | $2,754.23 |
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 $1,905.46 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,187.76 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,089.30 | $2,630.27 |
Medcost Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $3,548.13 | Facility | None | $2,344.23 | $2,344.23 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,691.53 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,691.53 | $2,951.21 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $8,912.51 | Facility | None | $933.25 | $2,454.71 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $4,168.69 | Professional | None | $1,995.26 | $3,162.28 | $4,168.69 |
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 $1,584.89 Median $2,238.72 Typical High $4,677.35 | Professional | None | $1,584.89 | $2,238.72 | $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 $1,174.90 Median $1,202.26 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,174.90 | $1,202.26 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $489.78 | Professional | 53 · Discontinued | $467.74 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $239.88 Typical High $245.47 | Professional | 56 · Pre-op care only | $234.42 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,737.80 |
Where Virginia sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 42nd of 51
$2,042
AK $8,511KY $871
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.