How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,096 to $12,303Professionalmedian $1,479 · 10th to 90th $1,202 to $1,820
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 $1,584.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,584.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,548.82 | $1,548.82 | $1,584.89 |
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 $1,258.93 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $933.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $794.33 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $234.42 Typical High $288.40 | Professional | 80 · Assistant surgeon | $204.17 | $234.42 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $251.19 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,479.11 | $1,698.24 |
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 $1,230.27 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,412.54 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,412.54 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,949.84 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,511.89 | Facility | None | $1,548.82 | $1,698.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,445.44 | $2,089.30 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $6,456.54 | Facility | None | $1,023.29 | $1,949.84 | $6,456.54 |
Sentara Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,479.11 | $2,187.76 |
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 $1,000.00 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,288.25 | $2,238.72 |
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 $758.58 Median $758.58 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,096.48 |
Where Virginia sits
The same service costs 5.4 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· 33rd of 51
$1,479
AK $4,677TX $871
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.