How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $10,000Professionalmedian $2,512 · 10th to 90th $2,042 to $3,020
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 $2,691.53 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,691.53 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,570.40 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $6,456.54 Typical High $10,964.78 | Facility | None | $2,454.71 | $6,456.54 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,511.89 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,584.89 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,318.26 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $478.63 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $426.58 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $2,884.03 | Professional | None | $2,238.72 | $2,511.89 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,949.84 | $2,398.83 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $3,388.44 | Professional | None | $2,089.30 | $2,398.83 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,511.89 | $3,162.28 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $4,168.69 | Facility | None | $2,570.40 | $2,818.38 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,187.76 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $8,511.38 | Facility | None | $1,348.96 | $2,454.71 | $8,511.38 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,344.23 | $3,467.37 |
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 $1,621.81 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,137.96 | $3,630.78 |
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 $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 53 · Discontinued | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,862.09 |
Where Virginia sits
The same service costs 20.9 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· 32nd of 51
$2,512
AK $7,586TX $363
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.