How much rates vary
Facilitymedian $5,495 · 10th to 90th $955 to $24,547Professionalmedian $1,380 · 10th to 90th $1,148 to $2,089
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 $5,495.41 Typical High $14,125.38 | Facility | None | $1,380.38 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $15,488.17 Typical High $28,840.32 | Facility | None | $6,456.54 | $15,488.17 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,412.54 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $288.40 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $288.40 |
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 $1,230.27 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,380.38 | $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 $1,380.38 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,380.38 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,380.38 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,819.70 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,290.87 | Facility | None | $1,380.38 | $1,513.56 | $2,290.87 |
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 $1,621.81 Typical High $10,232.93 | Facility | None | $933.25 | $1,621.81 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $3,388.44 | Professional | None | $1,096.48 | $1,584.89 | $3,388.44 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $5,888.44 | Facility | None | $588.84 | $2,187.76 | $5,888.44 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,344.23 | Professional | None | $977.24 | $1,479.11 | $2,344.23 |
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 $616.60 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $954.99 |
Where Virginia sits
The same service costs 5.6 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
$1,479
AK $5,012TX $891
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.