How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,148 to $12,023Professionalmedian $1,698 · 10th to 90th $1,413 to $2,512
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 $1,698.24 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,698.24 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,698.24 | $1,862.09 |
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 $1,412.54 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,412.54 | $1,659.59 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $302.00 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,698.24 | $2,238.72 |
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 $1,479.11 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,737.80 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,548.82 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,949.84 | $2,454.71 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,818.38 | Facility | None | $1,698.24 | $2,290.87 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Sentara Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,174.90 | $1,995.26 | $6,918.31 |
Sentara Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,995.26 | $3,715.35 |
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 $1,258.93 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,995.26 | $3,090.30 |
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 $794.33 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,202.26 | $1,202.26 |
Where Virginia sits
The same service costs 6.0 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· 33rd of 51
$1,778
AK $6,026TX $1,000
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.