How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,047 to $16,982Professionalmedian $1,413 · 10th to 90th $1,122 to $2,188
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 $1,380.38 Median $7,762.47 Typical High $15,488.17 | Facility | None | $1,380.38 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $4,365.16 | Professional | None | $1,023.29 | $1,380.38 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $11,220.18 Typical High $19,952.62 | Facility | None | $4,466.84 | $11,220.18 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,122.02 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $281.84 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $251.19 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,412.54 | $1,819.70 |
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 $1,148.15 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,412.54 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,258.93 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,698.24 | $2,137.96 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,380.38 | $1,698.24 | $2,290.87 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Sentara Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $7,413.10 | Facility | None | $954.99 | $1,862.09 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,621.81 | $3,090.30 |
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 $1,047.13 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,659.59 | $2,454.71 |
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 $512.86 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $512.86 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $204.17 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $776.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $154.88 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $102.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $724.44 | $977.24 | $977.24 |
Where Virginia sits
The same service costs 7.1 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· 35th of 51
$1,479
AK $5,012TX $708
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.