How much rates vary
Facilitymedian $3,467 · 10th to 90th $759 to $8,128Professionalmedian $3,890 · 10th to 90th $3,236 to $4,677
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 $4,073.80 Median $4,073.80 Typical High $4,168.69 | Professional | None | $4,073.80 | $4,073.80 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,981.07 Typical High $4,677.35 | Professional | None | $3,311.31 | $3,981.07 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,511.89 Typical High $2,951.21 | Professional | 62 · Two surgeons | $2,089.30 | $2,511.89 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $645.65 Typical High $758.58 | Professional | 80 · Assistant surgeon | $537.03 | $645.65 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $562.34 Typical High $660.69 | Professional | AS · PA/NP assist | $467.74 | $562.34 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $4,466.84 | Professional | None | $3,467.37 | $3,890.45 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $3,630.78 Typical High $5,495.41 | Professional | None | $3,162.28 | $3,630.78 | $5,495.41 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $5,370.32 Typical High $5,370.32 | Professional | None | $4,265.80 | $5,370.32 | $5,370.32 |
Medcost Setting Facility Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $6,606.93 | Facility | None | $4,073.80 | $4,466.84 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,786.30 | Professional | None | $3,548.13 | $3,548.13 | $4,786.30 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $3,388.44 Typical High $10,232.93 | Facility | None | $1,737.80 | $3,388.44 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $5,623.41 | Professional | None | $3,235.94 | $3,890.45 | $5,623.41 |
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 $2,630.27 Median $3,388.44 Typical High $5,754.40 | Professional | None | $2,630.27 | $3,388.44 | $5,754.40 |
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 $2,041.74 Median $2,041.74 Typical High $2,089.30 | Professional | 52 · Reduced service | $2,041.74 | $2,041.74 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 53 · Discontinued | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,090.30 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $416.87 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $2,884.03 |
Where Virginia sits
The same service costs 27.5 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· 30th of 51
$3,890
AK $14,454TX $525
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.