How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,148 to $12,303Professionalmedian $1,622 · 10th to 90th $1,349 to $1,995
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 $1,737.80 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,737.80 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,698.24 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $7,413.10 Typical High $14,125.38 | Facility | None | $3,162.28 | $7,413.10 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,621.81 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,023.29 Typical High $1,230.27 | Professional | 62 · Two surgeons | $870.96 | $1,023.29 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $316.23 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | AS · PA/NP assist | $190.55 | $229.09 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,621.81 | $1,862.09 |
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 $1,348.96 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,548.82 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,513.56 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,778.28 | $2,344.23 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,754.23 | Facility | None | $1,659.59 | $1,905.46 | $2,754.23 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,380.38 | $1,819.70 |
Sentara Setting Facility Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $6,760.83 | Facility | None | $1,174.90 | $2,089.30 | $6,760.83 |
Sentara Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,621.81 | $2,344.23 |
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 $1,096.48 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,412.54 | $2,398.83 |
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 $831.76 Median $831.76 Typical High $870.96 | Professional | 52 · Reduced service | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,202.26 |
Where Virginia sits
The same service costs 5.2 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· 32nd of 51
$1,622
AK $5,129TX $977
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.