How much rates vary
Facilitymedian $5,495 · 10th to 90th $891 to $21,878Professionalmedian $1,202 · 10th to 90th $891 to $1,622
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 $1,202.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $13,489.63 Typical High $25,703.96 | Facility | None | $5,754.40 | $13,489.63 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,862.09 Typical High $2,238.72 | Professional | 50 · Both sides | $1,548.82 | $1,862.09 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $933.25 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | 80 · Assistant surgeon | $165.96 | $199.53 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $173.78 Typical High $208.93 | Professional | AS · PA/NP assist | $144.54 | $173.78 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,230.27 | $1,258.93 |
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 $758.58 Median $1,071.52 Typical High $1,621.81 | Professional | None | $758.58 | $1,071.52 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,230.27 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,348.96 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,041.74 | Facility | None | $1,148.15 | $1,148.15 | $2,041.74 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $3,162.28 | Professional | None | $1,000.00 | $1,071.52 | $3,162.28 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $7,413.10 | Facility | None | $851.14 | $1,778.28 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $2,511.89 | Professional | None | $831.76 | $1,122.02 | $2,511.89 |
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 $724.44 Median $977.24 Typical High $1,949.84 | Professional | None | $724.44 | $977.24 | $1,949.84 |
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 $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $851.14 |
Where Virginia sits
The same service costs 21.9 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· 33rd of 51
$1,202
AK $4,467TX $204
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.