How much rates vary
Facilitymedian $4,786 · 10th to 90th $871 to $17,378Professionalmedian $1,072 · 10th to 90th $891 to $1,622
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 $1,071.52 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,071.52 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,071.52 | $1,174.90 |
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 $891.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $891.25 | $1,047.13 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,584.89 Typical High $2,041.74 | Professional | 50 · Both sides | $1,318.26 | $1,584.89 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $851.14 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $141.25 | $169.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $147.91 Typical High $190.55 | Professional | AS · PA/NP assist | $123.03 | $147.91 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,412.54 | Professional | None | $954.99 | $1,071.52 | $1,412.54 |
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 $933.25 Median $1,096.48 Typical High $1,621.81 | Professional | None | $933.25 | $1,096.48 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,230.27 | Professional | None | $831.76 | $977.24 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,778.28 | Facility | None | $1,071.52 | $1,412.54 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Sentara Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $7,413.10 | Facility | None | $870.96 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $2,344.23 | Professional | None | $891.25 | $1,258.93 | $2,344.23 |
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 $776.25 Median $1,230.27 Typical High $1,905.46 | Professional | None | $776.25 | $1,230.27 | $1,905.46 |
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 $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $758.58 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $758.58 |
Where Virginia sits
The same service costs 7.9 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
$1,122
AK $3,802TX $479
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.