How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,122 to $24,547Professionalmedian $1,778 · 10th to 90th $1,479 to $2,630
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 $1,778.28 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,778.28 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,778.28 | $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 $1,479.11 Median $1,778.28 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,778.28 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $281.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $239.88 | $281.84 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $316.23 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,737.80 | $2,290.87 |
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 $1,479.11 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,737.80 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,737.80 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,511.89 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,884.03 | Facility | None | $1,778.28 | $1,995.26 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Sentara Setting Facility Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $10,232.93 | Facility | None | $1,258.93 | $2,089.30 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,479.11 | $1,995.26 | $3,801.89 |
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 $1,288.25 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,995.26 | $3,019.95 |
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 $794.33 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,230.27 |
Where Virginia sits
The same service costs 7.2 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
$1,862
AK $6,457TX $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.