How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,122 to $12,023Professionalmedian $1,585 · 10th to 90th $1,288 to $2,291
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 $1,584.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,584.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $1,698.24 | Professional | None | $1,548.82 | $1,584.89 | $1,698.24 |
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 $1,318.26 Median $1,584.89 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,584.89 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | 62 · Two surgeons | $831.76 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $323.59 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $281.84 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,621.81 | $2,089.30 |
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 $1,348.96 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,548.82 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,570.40 | Facility | None | $1,584.89 | $1,778.28 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Sentara Setting Facility Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $6,309.57 | Facility | None | $1,122.02 | $1,995.26 | $6,309.57 |
Sentara Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,737.80 | $3,467.37 |
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 $1,148.15 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,737.80 | $2,754.23 |
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 $758.58 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,096.48 |
Where Virginia sits
The same service costs 21.4 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· 32nd of 51
$1,660
AK $5,754TX $269
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.