How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,259 to $24,547Professionalmedian $2,692 · 10th to 90th $2,188 to $3,890
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 $2,691.53 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,691.53 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,691.53 | $2,818.38 |
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 $2,238.72 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,691.53 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,698.24 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,412.54 | $1,698.24 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $426.58 Typical High $549.54 | Professional | 80 · Assistant surgeon | $354.81 | $426.58 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $371.54 Typical High $478.63 | Professional | AS · PA/NP assist | $316.23 | $371.54 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $3,467.37 | Professional | None | $2,344.23 | $2,630.27 | $3,467.37 |
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 $2,238.72 Median $2,630.27 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,630.27 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,570.40 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $3,090.30 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,090.30 | $3,890.45 | $3,890.45 |
Medcost Setting Facility Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $4,365.16 | Facility | None | $2,691.53 | $3,019.95 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Sentara Setting Facility Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $10,715.19 | Facility | None | $1,445.44 | $2,570.40 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $5,623.41 | Professional | None | $2,187.76 | $2,951.21 | $5,623.41 |
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 $1,949.84 Median $3,019.95 Typical High $4,570.88 | Professional | None | $1,949.84 | $3,019.95 | $4,570.88 |
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 $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,202.26 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,778.28 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $354.81 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,905.46 | $1,905.46 |
Where Virginia sits
The same service costs 14.1 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· 33rd of 51
$2,754
AK $9,772TX $692
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.