How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $10,233Professionalmedian $4,571 · 10th to 90th $3,715 to $5,623
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 $4,786.30 Median $4,786.30 Typical High $4,897.79 | Professional | None | $4,786.30 | $4,786.30 | $4,897.79 |
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 $3,890.45 Median $4,570.88 Typical High $5,495.41 | Professional | None | $3,890.45 | $4,570.88 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,454.71 Median $2,884.03 Typical High $3,467.37 | Professional | 62 · Two surgeons | $2,454.71 | $2,884.03 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $616.60 Median $741.31 Typical High $891.25 | Professional | 80 · Assistant surgeon | $616.60 | $741.31 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $549.54 Median $645.65 Typical High $776.25 | Professional | AS · PA/NP assist | $549.54 | $645.65 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $4,365.16 Median $4,786.30 Typical High $5,495.41 | Professional | None | $4,365.16 | $4,786.30 | $5,495.41 |
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 $3,630.78 Median $4,365.16 Typical High $6,025.60 | Professional | None | $3,630.78 | $4,365.16 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $6,456.54 | Professional | None | $3,715.35 | $4,265.80 | $6,456.54 |
Medcost Setting Professional Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,677.35 | $5,888.44 | $5,888.44 |
Medcost Setting Facility Modifier None Typical Low $4,786.30 Median $5,370.32 Typical High $7,762.47 | Facility | None | $4,786.30 | $5,370.32 | $7,762.47 |
Medcost Setting Professional Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $5,011.87 | Professional | None | $3,311.31 | $3,388.44 | $5,011.87 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $4,073.80 Typical High $10,232.93 | Facility | None | $1,737.80 | $4,073.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $6,309.57 | Professional | None | $3,630.78 | $4,365.16 | $6,309.57 |
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 $3,019.95 Median $3,981.07 Typical High $6,606.93 | Professional | None | $3,019.95 | $3,981.07 | $6,606.93 |
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 $2,398.83 Median $2,398.83 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,398.83 | $2,398.83 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | 53 · Discontinued | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,548.13 Median $3,548.13 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,548.13 | $3,548.13 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $724.44 Typical High $741.31 | Professional | 55 · Aftercare only | $724.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 56 · Pre-op care only | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,311.31 Median $3,311.31 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $3,311.31 | $3,311.31 | $3,467.37 |
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· 31st of 51
$4,571
AK $14,125TX $646
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.