How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,000 to $17,378Professionalmedian $1,230 · 10th to 90th $1,000 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 $1,230.27 Median $7,762.47 Typical High $15,488.17 | Facility | None | $1,230.27 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $4,365.16 | Professional | None | $1,148.15 | $1,230.27 | $4,365.16 |
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 $1,000.00 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,202.26 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $977.24 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $245.47 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,230.27 | $1,621.81 |
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 $1,047.13 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,230.27 | $1,862.09 |
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 $1,445.44 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,778.28 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,995.26 | Facility | None | $1,230.27 | $1,584.89 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $7,413.10 | Facility | None | $933.25 | $1,778.28 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,412.54 | $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 $891.25 Median $1,445.44 Typical High $2,187.76 | Professional | None | $891.25 | $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 $575.44 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $229.09 | $245.47 | $245.47 |
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 $114.82 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $123.03 |
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
$1,288
AK $4,365TX $741
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.