How much rates vary
Facilitymedian $4,074 · 10th to 90th $813 to $12,023Professionalmedian $1,000 · 10th to 90th $832 to $1,514
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 $1,000.00 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,000.00 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,096.48 | Professional | None | $933.25 | $1,000.00 | $1,096.48 |
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 $831.76 Median $977.24 Typical High $1,258.93 | Professional | None | $831.76 | $977.24 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,479.11 Typical High $1,905.46 | Professional | 50 · Both sides | $1,230.27 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $794.33 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $204.17 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $177.83 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $177.83 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,318.26 | Professional | None | $912.01 | $1,000.00 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,548.82 | Professional | None | $870.96 | $1,023.29 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,148.15 | Professional | None | $776.25 | $912.01 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,412.54 | $1,412.54 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,659.59 | Facility | None | $1,000.00 | $1,318.26 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $5,495.41 | Facility | None | $812.83 | $1,737.80 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $2,290.87 | Professional | None | $831.76 | $1,174.90 | $2,290.87 |
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 $724.44 Median $1,148.15 Typical High $1,778.28 | Professional | None | $724.44 | $1,148.15 | $1,778.28 |
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 $467.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $707.95 |
Where Virginia sits
The same service costs 5.6 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
$1,047
AK $3,548UT $631
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.