How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,023 to $12,023Professionalmedian $1,259 · 10th to 90th $1,023 to $1,905
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 $1,258.93 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,258.93 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,258.93 | $1,348.96 |
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 $1,023.29 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,230.27 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $776.25 Typical High $977.24 | Professional | 62 · Two surgeons | $645.65 | $776.25 | $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 $144.54 Median $169.82 Typical High $218.78 | Professional | AS · PA/NP assist | $144.54 | $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 $1,071.52 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,288.25 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,412.54 | Professional | None | $954.99 | $1,122.02 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,041.74 | Facility | None | $1,258.93 | $1,584.89 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $5,495.41 | Facility | None | $933.25 | $1,778.28 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,479.11 | $2,691.53 |
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 $912.01 Median $1,445.44 Typical High $2,187.76 | Professional | None | $912.01 | $1,445.44 | $2,187.76 |
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 $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $870.96 |
Where Virginia sits
The same service costs 5.9 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· 34th of 51
$1,318
AK $4,467TX $759
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.