How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,122 to $17,378Professionalmedian $1,660 · 10th to 90th $1,349 to $2,399
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 $1,659.59 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,659.59 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,659.59 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,964.78 Typical High $20,417.38 | Facility | None | $4,570.88 | $10,964.78 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,621.81 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,398.83 Typical High $3,090.30 | Professional | 50 · Both sides | $2,041.74 | $2,398.83 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,023.29 Typical High $1,288.25 | Professional | 62 · Two surgeons | $851.14 | $1,023.29 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $257.04 Typical High $331.13 | Professional | 80 · Assistant surgeon | $213.80 | $257.04 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $288.40 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,621.81 | $2,137.96 |
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 $1,412.54 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,659.59 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,479.11 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,905.46 | $2,398.83 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $2,691.53 | Facility | None | $1,659.59 | $2,187.76 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $7,585.78 | Facility | None | $1,122.02 | $1,995.26 | $7,585.78 |
Sentara Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,548.13 | Professional | None | $1,380.38 | $1,905.46 | $3,548.13 |
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 $1,202.26 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,949.84 | $2,951.21 |
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 $776.25 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $776.25 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $309.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,148.15 |
Where Virginia sits
The same service costs 5.9 times more in Alaska than in Utah. 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
$1,698
AK $5,888UT $1,000
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.