How much rates vary
Facilitymedian $4,898 · 10th to 90th $933 to $17,378Professionalmedian $1,230 · 10th to 90th $1,023 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 $1,174.90 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,174.90 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,174.90 | $1,318.26 |
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 $1,023.29 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,202.26 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,344.23 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $977.24 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $251.19 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $218.78 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $218.78 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,230.27 | $1,621.81 |
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 $1,047.13 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,202.26 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,445.44 | Professional | None | $977.24 | $1,174.90 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,995.26 | Facility | None | $1,174.90 | $1,380.38 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $7,413.10 | Facility | None | $933.25 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,630.27 | Professional | None | $954.99 | $1,348.96 | $2,630.27 |
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 $891.25 Median $1,348.96 Typical High $2,089.30 | Professional | None | $891.25 | $1,348.96 | $2,089.30 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
Where Virginia sits
The same service costs 6.6 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
$1,288
AK $4,365TX $661
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.