How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,148 to $24,547Professionalmedian $1,905 · 10th to 90th $1,585 to $2,884
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 $1,905.46 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,905.46 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $3,548.13 | Professional | None | $1,737.80 | $1,905.46 | $3,548.13 |
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 $1,621.81 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,905.46 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,202.26 Typical High $1,548.82 | Professional | 62 · Two surgeons | $1,023.29 | $1,202.26 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $346.74 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,698.24 | $1,905.46 | $2,454.71 |
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 $1,621.81 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,862.09 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,818.38 | $2,818.38 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $3,162.28 | Facility | None | $1,905.46 | $2,137.96 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $10,232.93 | Facility | None | $1,288.25 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $4,073.80 | Professional | None | $1,621.81 | $2,137.96 | $4,073.80 |
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 $1,380.38 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,380.38 | $2,137.96 | $3,235.94 |
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 $851.14 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,348.96 | $1,348.96 |
Where Virginia sits
The same service costs 5.9 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· 32nd of 51
$2,042
AK $6,918TX $1,175
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.