How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $12,303Professionalmedian $2,692 · 10th to 90th $2,188 to $3,311
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 $2,884.03 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,884.03 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $2,884.03 | Professional | None | $2,754.23 | $2,818.38 | $2,884.03 |
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 $2,290.87 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,691.53 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,698.24 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,445.44 | $1,698.24 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $426.58 Typical High $524.81 | Professional | 80 · Assistant surgeon | $371.54 | $426.58 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $380.19 Typical High $457.09 | Professional | AS · PA/NP assist | $323.59 | $380.19 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $3,090.30 | Professional | None | $2,398.83 | $2,691.53 | $3,090.30 |
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 $2,238.72 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,238.72 | $2,570.40 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,981.07 | Professional | None | $2,187.76 | $2,511.89 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,630.27 | $3,548.13 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $2,754.23 Median $3,162.28 Typical High $4,570.88 | Facility | None | $2,754.23 | $3,162.28 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,290.87 | $3,019.95 |
Sentara Setting Facility Modifier None Typical Low $1,445.44 Median $2,691.53 Typical High $9,120.11 | Facility | None | $1,445.44 | $2,691.53 | $9,120.11 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,890.45 | Professional | None | $2,187.76 | $2,691.53 | $3,890.45 |
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 $1,778.28 Median $2,344.23 Typical High $3,981.07 | Professional | None | $1,778.28 | $2,344.23 | $3,981.07 |
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 $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 53 · Discontinued | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,137.96 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $426.58 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $288.40 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $1,995.26 |
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
$2,692
AK $8,318TX $389
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.