How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $12,303Professionalmedian $2,512 · 10th to 90th $2,042 to $3,090
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 $2,691.53 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,691.53 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,630.27 | $2,691.53 |
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 $2,137.96 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,511.89 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,584.89 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,348.96 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $489.78 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $354.81 Typical High $426.58 | Professional | AS · PA/NP assist | $295.12 | $354.81 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $2,884.03 | Professional | None | $2,238.72 | $2,511.89 | $2,884.03 |
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 $2,089.30 Median $2,398.83 Typical High $3,311.31 | Professional | None | $2,089.30 | $2,398.83 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,344.23 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,691.53 | $3,548.13 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,265.80 | Facility | None | $2,570.40 | $2,951.21 | $4,265.80 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,445.44 | $2,818.38 |
Sentara Setting Facility Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $8,709.64 | Facility | None | $1,348.96 | $2,511.89 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,511.89 | $3,630.78 |
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 $1,698.24 Median $2,187.76 Typical High $3,801.89 | Professional | None | $1,698.24 | $2,187.76 | $3,801.89 |
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 $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 53 · Discontinued | $524.81 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,862.09 |
Where Virginia sits
The same service costs 22.4 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· 34th of 51
$2,512
AK $7,943TX $355
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.