How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,072 to $17,378Professionalmedian $1,023 · 10th to 90th $832 to $1,622
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 $7,079.46 Typical High $14,125.38 | Facility | None | $1,000.00 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $4,168.69 | Professional | None | $758.58 | $1,000.00 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $10,715.19 Typical High $19,952.62 | Facility | None | $4,466.84 | $10,715.19 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,318.26 | Professional | None | $851.14 | $1,023.29 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,548.82 Typical High $1,949.84 | Professional | 50 · Both sides | $1,288.25 | $1,548.82 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $645.65 Typical High $831.76 | Professional | 62 · Two surgeons | $537.03 | $645.65 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $208.93 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $144.54 Typical High $181.97 | Professional | AS · PA/NP assist | $120.23 | $144.54 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $6,165.95 | Professional | None | $933.25 | $1,023.29 | $6,165.95 |
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 $831.76 Median $1,047.13 Typical High $1,548.82 | Professional | None | $831.76 | $1,047.13 | $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 $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,548.82 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,230.27 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $10,232.93 | Facility | None | $812.83 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $6,025.60 | Professional | None | $870.96 | $1,202.26 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $1,778.28 | Professional | None | $758.58 | $1,230.27 | $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 $380.19 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $707.95 | $707.95 |
Where Virginia sits
The same service costs 6.3 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· 38th of 51
$1,122
AK $3,715UT $589
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.