How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,514 to $14,791Professionalmedian $1,413 · 10th to 90th $1,148 to $1,698
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 $8,317.64 Typical High $18,620.87 | Facility | None | $1,513.56 | $8,317.64 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,513.56 | Professional | None | $1,412.54 | $1,412.54 | $1,513.56 |
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 $1,202.26 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,071.52 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $223.87 Typical High $269.15 | Professional | 80 · Assistant surgeon | $190.55 | $223.87 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $194.98 Typical High $239.88 | Professional | AS · PA/NP assist | $169.82 | $194.98 | $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 $1,148.15 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,148.15 | $1,348.96 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,318.26 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,905.46 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,344.23 | Facility | None | $1,412.54 | $1,621.81 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,445.44 | $1,584.89 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,412.54 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,089.30 | Professional | None | $954.99 | $1,230.27 | $2,089.30 |
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 $707.95 Median $707.95 Typical High $741.31 | Professional | 52 · Reduced service | $707.95 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,047.13 |
Where Virginia sits
The same service costs 26.3 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
$1,413
AK $5,248TX $200
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.