How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,175 to $24,547Professionalmedian $2,455 · 10th to 90th $1,995 to $3,548
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 $2,454.71 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,454.71 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,187.76 | $2,454.71 | $2,454.71 |
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 $2,041.74 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,041.74 | $2,454.71 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $389.05 Typical High $501.19 | Professional | 80 · Assistant surgeon | $323.59 | $389.05 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $338.84 Typical High $436.52 | Professional | AS · PA/NP assist | $288.40 | $338.84 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,398.83 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,290.87 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,884.03 | Professional | None | $1,949.84 | $2,344.23 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,511.89 | $3,162.28 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $3,981.07 | Facility | None | $2,454.71 | $2,570.40 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $10,232.93 | Facility | None | $1,288.25 | $2,398.83 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,570.40 | $5,128.61 |
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 $1,698.24 Median $2,570.40 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,570.40 | $4,073.80 |
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 $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,096.48 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,621.81 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,737.80 | $1,737.80 |
Where Virginia sits
The same service costs 8.1 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· 31st of 51
$2,512
AK $8,913TX $1,096
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.