How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,047 to $12,303Professionalmedian $1,288 · 10th to 90th $1,072 to $1,995
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 $1,288.25 Median $7,244.36 Typical High $14,125.38 | Facility | None | $1,288.25 | $7,244.36 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $4,365.16 | Professional | None | $1,202.26 | $1,288.25 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $13,803.84 | Facility | None | $3,090.30 | $7,413.10 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $794.33 Typical High $1,023.29 | Professional | 62 · Two surgeons | $660.69 | $794.33 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $229.09 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,288.25 | $1,698.24 |
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 $1,096.48 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,318.26 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,174.90 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,862.09 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,288.25 | $1,698.24 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $5,495.41 | Facility | None | $933.25 | $1,862.09 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,513.56 | $2,818.38 |
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 $954.99 Median $1,513.56 Typical High $2,290.87 | Professional | None | $954.99 | $1,513.56 | $2,290.87 |
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 $602.56 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $912.01 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $912.01 |
Where Virginia sits
The same service costs 5.8 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
$1,349
AK $4,571UT $794
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.