How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,259 to $24,547Professionalmedian $2,951 · 10th to 90th $2,399 to $4,266
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 $2,884.03 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,884.03 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,630.27 | $2,884.03 | $3,235.94 |
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 $2,454.71 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,454.71 | $2,951.21 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $1,862.09 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,548.82 | $1,862.09 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $467.74 Typical High $602.56 | Professional | 80 · Assistant surgeon | $389.05 | $467.74 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $407.38 Typical High $524.81 | Professional | AS · PA/NP assist | $338.84 | $407.38 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $3,715.35 | Professional | None | $2,570.40 | $2,884.03 | $3,715.35 |
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 $2,454.71 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,454.71 | $2,884.03 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,290.87 | $2,754.23 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,467.37 | $4,365.16 | $4,365.16 |
Medcost Setting Facility Modifier None Typical Low $2,884.03 Median $3,311.31 Typical High $4,786.30 | Facility | None | $2,884.03 | $3,311.31 | $4,786.30 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Sentara Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $11,481.54 | Facility | None | $1,548.82 | $2,884.03 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $2,238.72 Median $3,235.94 Typical High $6,165.95 | Professional | None | $2,238.72 | $3,235.94 | $6,165.95 |
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 $2,089.30 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,089.30 | $3,311.31 | $4,897.79 |
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 $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,949.84 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,041.74 | $2,041.74 |
Where Virginia sits
The same service costs 17.0 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· 31st of 51
$3,090
AK $10,471TX $617
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.