How much rates vary
Facilitymedian $4,169 · 10th to 90th $851 to $12,303Professionalmedian $1,096 · 10th to 90th $912 to $1,349
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 $1,202.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
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 $933.25 Median $1,122.02 Typical High $1,318.26 | Professional | None | $933.25 | $1,122.02 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $831.76 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $213.80 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $186.21 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,096.48 | $1,258.93 |
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 $912.01 Median $1,071.52 Typical High $1,479.11 | Professional | None | $912.01 | $1,071.52 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,412.54 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,862.09 | Facility | None | $1,122.02 | $1,202.26 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,174.90 | $1,862.09 |
Sentara Setting Facility Modifier None Typical Low $831.76 Median $1,737.80 Typical High $6,165.95 | Facility | None | $831.76 | $1,737.80 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,621.81 | Professional | None | $831.76 | $1,096.48 | $1,621.81 |
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 $724.44 Median $954.99 Typical High $1,659.59 | Professional | None | $724.44 | $954.99 | $1,659.59 |
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 $562.34 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $562.34 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $831.76 |
Where Virginia sits
The same service costs 4.9 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· 35th of 51
$1,096
AK $3,548TX $724
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.