How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,349 to $21,380Professionalmedian $1,380 · 10th to 90th $1,148 to $1,698
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 $2,511.89 Median $7,585.78 Typical High $16,595.87 | Facility | None | $2,511.89 | $7,585.78 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,380.38 | $1,445.44 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,047.13 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $234.42 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,380.38 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,897.79 Typical High $9,772.37 | Facility | None | $512.86 | $4,897.79 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,318.26 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,288.25 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,344.23 | Facility | None | $1,380.38 | $1,621.81 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,737.80 | Professional | None | $891.25 | $1,174.90 | $1,737.80 |
Sentara Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $18,620.87 | Facility | None | $1,000.00 | $3,090.30 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,348.96 | $2,089.30 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,489.63 Typical High $36,307.81 | Facility | None | $4,570.88 | $13,489.63 | $36,307.81 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $2,041.74 | Professional | None | $933.25 | $1,202.26 | $2,041.74 |
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 $691.83 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $691.83 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,023.29 |
Where Virginia sits
The same service costs 25.7 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
$1,380
AK $5,129TX $200
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.