How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $10,233Professionalmedian $4,169 · 10th to 90th $3,467 to $5,129
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 $3,801.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,801.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,570.88 | Professional | None | $4,365.16 | $4,365.16 | $4,570.88 |
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 $3,548.13 Median $4,265.80 Typical High $5,128.61 | Professional | None | $3,548.13 | $4,265.80 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,238.72 Median $2,691.53 Typical High $3,235.94 | Professional | 62 · Two surgeons | $2,238.72 | $2,691.53 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $676.08 Typical High $812.83 | Professional | 80 · Assistant surgeon | $575.44 | $676.08 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $588.84 Typical High $724.44 | Professional | AS · PA/NP assist | $501.19 | $588.84 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $3,981.07 Median $4,466.84 Typical High $5,128.61 | Professional | None | $3,981.07 | $4,466.84 | $5,128.61 |
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 $3,388.44 Median $4,073.80 Typical High $5,495.41 | Professional | None | $3,388.44 | $4,073.80 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,467.37 Median $3,981.07 Typical High $5,754.40 | Professional | None | $3,467.37 | $3,981.07 | $5,754.40 |
Medcost Setting Professional Modifier None Typical Low $4,466.84 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,466.84 | $5,888.44 | $5,888.44 |
Medcost Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $7,244.36 | Facility | None | $4,365.16 | $5,128.61 | $7,244.36 |
Medcost Setting Professional Modifier None Typical Low $3,019.95 Median $3,090.30 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,090.30 | $4,570.88 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $10,232.93 | Facility | None | $1,737.80 | $3,890.45 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $3,388.44 Median $4,073.80 Typical High $5,888.44 | Professional | None | $3,388.44 | $4,073.80 | $5,888.44 |
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 $2,951.21 Median $3,715.35 Typical High $6,165.95 | Professional | None | $2,951.21 | $3,715.35 | $6,165.95 |
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 $2,187.76 Median $2,187.76 Typical High $2,238.72 | Professional | 52 · Reduced service | $2,187.76 | $2,187.76 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $912.01 | Professional | 53 · Discontinued | $891.25 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $3,388.44 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | 56 · Pre-op care only | $436.52 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $3,162.28 |
Where Virginia sits
The same service costs 21.9 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· 34th of 51
$4,169
AK $13,183TX $603
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.