How much rates vary
Facilitymedian $2,692 · 10th to 90th $891 to $6,310Professionalmedian $1,259 · 10th to 90th $1,047 to $1,549
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 $1,348.96 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,348.96 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | None | $1,318.26 | $1,318.26 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $6,456.54 | Facility | None | $1,445.44 | $3,715.35 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $977.24 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $245.47 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $213.80 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,258.93 | $1,479.11 |
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 $1,047.13 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,230.27 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,202.26 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,584.89 | $1,584.89 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,137.96 | Facility | None | $1,318.26 | $1,445.44 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,412.54 | Professional | None | $851.14 | $870.96 | $1,412.54 |
Sentara Setting Facility Modifier None Typical Low $870.96 Median $1,548.82 Typical High $5,248.07 | Facility | None | $870.96 | $1,548.82 | $5,248.07 |
Sentara Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,862.09 | Professional | None | $912.01 | $1,258.93 | $1,862.09 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,905.46 | Professional | None | $831.76 | $1,096.48 | $1,905.46 |
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 $660.69 Median $660.69 Typical High $676.08 | Professional | 52 · Reduced service | $660.69 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $954.99 |
Where Virginia sits
The same service costs 5.5 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
$1,259
AK $4,266TX $776
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.