How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $17,378Professionalmedian $1,995 · 10th to 90th $1,622 to $2,951
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 $1,995.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,995.26 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,137.96 | Professional | None | $1,862.09 | $1,995.26 | $2,137.96 |
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 $1,621.81 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,949.84 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,230.27 Typical High $1,584.89 | Professional | 62 · Two surgeons | $1,023.29 | $1,230.27 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $275.42 Typical High $346.74 | Professional | AS · PA/NP assist | $229.09 | $275.42 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,778.28 | $1,995.26 | $2,570.40 |
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 $1,698.24 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,698.24 | $2,041.74 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,778.28 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,290.87 | $2,884.03 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,995.26 | $2,630.27 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $8,317.64 | Facility | None | $1,288.25 | $2,187.76 | $8,317.64 |
Sentara Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $4,365.16 | Professional | None | $1,659.59 | $2,290.87 | $4,365.16 |
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 $1,445.44 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,445.44 | $2,344.23 | $3,548.13 |
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 $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $933.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,380.38 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,412.54 | $1,412.54 |
Where Virginia sits
The same service costs 5.9 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· 34th of 51
$2,042
AK $7,079UT $1,202
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.