How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,259 to $24,547Professionalmedian $2,884 · 10th to 90th $2,344 to $4,074
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 $2,570.40 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,884.03 | $2,884.03 |
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 $2,398.83 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,398.83 | $2,818.38 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,778.28 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,513.56 | $1,778.28 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $457.09 Typical High $575.44 | Professional | 80 · Assistant surgeon | $380.19 | $457.09 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $398.11 Typical High $512.86 | Professional | AS · PA/NP assist | $331.13 | $398.11 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $3,630.78 | Professional | None | $2,511.89 | $2,754.23 | $3,630.78 |
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 $2,344.23 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,344.23 | $2,754.23 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,238.72 | $2,691.53 | $3,311.31 |
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 $2,884.03 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,884.03 | $3,019.95 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Sentara Setting Facility Modifier None Typical Low $1,479.11 Median $2,818.38 Typical High $11,220.18 | Facility | None | $1,479.11 | $2,818.38 | $11,220.18 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $5,888.44 | Professional | None | $2,187.76 | $3,019.95 | $5,888.44 |
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 $1,995.26 Median $3,090.30 Typical High $4,786.30 | Professional | None | $1,995.26 | $3,090.30 | $4,786.30 |
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 $1,258.93 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,905.46 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,995.26 | $1,995.26 |
Where Virginia sits
The same service costs 10.0 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· 32nd of 51
$2,951
AK $10,233TX $1,023
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.