How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $24,547Professionalmedian $1,148 · 10th to 90th $933 to $1,698
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 $1,122.02 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,122.02 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,122.02 | $1,148.15 |
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 $954.99 Median $1,148.15 Typical High $1,479.11 | Professional | None | $954.99 | $1,148.15 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $724.44 Typical High $933.25 | Professional | 62 · Two surgeons | $602.56 | $724.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $234.42 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $204.17 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,148.15 | $1,479.11 |
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 $933.25 Median $1,096.48 Typical High $1,698.24 | Professional | None | $933.25 | $1,096.48 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,412.54 | Professional | None | $954.99 | $1,148.15 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,862.09 | Facility | None | $1,122.02 | $1,230.27 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $10,232.93 | Facility | None | $851.14 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,511.89 | Professional | None | $891.25 | $1,288.25 | $2,511.89 |
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 $794.33 Median $1,230.27 Typical High $1,905.46 | Professional | None | $794.33 | $1,230.27 | $1,905.46 |
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 $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $794.33 |
Where Virginia sits
The same service costs 18.6 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· 34th of 51
$1,202
AK $4,169TX $224
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.