How much rates vary
Facilitymedian $5,495 · 10th to 90th $933 to $24,547Professionalmedian $1,318 · 10th to 90th $1,072 to $1,995
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 $1,258.93 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,258.93 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,258.93 | $1,659.59 |
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 $1,148.15 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,380.38 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,096.48 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $218.78 Typical High $281.84 | Professional | 80 · Assistant surgeon | $181.97 | $218.78 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $245.47 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,348.96 | $1,778.28 |
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 $1,023.29 Median $1,202.26 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,202.26 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,445.44 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $2,187.76 | Facility | None | $1,258.93 | $1,288.25 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $1,862.09 Typical High $10,232.93 | Facility | None | $851.14 | $1,862.09 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,884.03 | Professional | None | $954.99 | $1,445.44 | $2,884.03 |
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 $912.01 Median $1,318.26 Typical High $2,238.72 | Professional | None | $912.01 | $1,318.26 | $2,238.72 |
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 $602.56 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $602.56 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $245.47 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $912.01 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $870.96 |
Where Virginia sits
The same service costs 5.6 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· 27th of 51
$1,445
AK $5,012UT $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.