How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,122 to $24,547Professionalmedian $1,549 · 10th to 90th $1,288 to $2,239
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 $1,513.56 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,513.56 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,513.56 | $1,778.28 |
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 $1,288.25 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,548.82 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,258.93 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $251.19 Typical High $316.23 | Professional | 80 · Assistant surgeon | $208.93 | $251.19 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $218.78 Typical High $275.42 | Professional | AS · PA/NP assist | $181.97 | $218.78 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,513.56 | $1,995.26 |
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 $1,288.25 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,513.56 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,698.24 | $2,137.96 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,511.89 | Facility | None | $1,513.56 | $1,698.24 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Sentara Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $10,232.93 | Facility | None | $1,071.52 | $1,905.46 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,288.25 | $1,737.80 | $3,311.31 |
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 $1,096.48 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,737.80 | $2,570.40 |
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 $691.83 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $691.83 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $275.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,071.52 |
Where Virginia sits
The same service costs 5.8 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· 34th of 51
$1,622
AK $5,623TX $977
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.