How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,000 to $12,303Professionalmedian $1,230 · 10th to 90th $1,023 to $1,549
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 $1,318.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,318.26 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,288.25 | $1,288.25 | $1,318.26 |
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 $1,071.52 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,258.93 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $954.99 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $239.88 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $208.93 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,230.27 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,174.90 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,000.00 | $1,148.15 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,862.09 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,089.30 | Facility | None | $1,288.25 | $1,479.11 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,513.56 | $2,398.83 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $6,165.95 | Facility | None | $933.25 | $1,819.70 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,230.27 | $1,819.70 |
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 $831.76 Median $1,071.52 Typical High $1,862.09 | Professional | None | $831.76 | $1,071.52 | $1,862.09 |
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 $645.65 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $933.25 |
Where Virginia sits
The same service costs 5.6 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· 35th of 51
$1,230
AK $4,266TX $759
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.