How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,023 to $11,482Professionalmedian $1,288 · 10th to 90th $1,047 to $1,820
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 $1,318.26 Median $4,786.30 Typical High $10,000.00 | Facility | None | $1,318.26 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,318.26 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,318.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,995.26 Typical High $2,398.83 | Professional | 50 · Both sides | $1,659.59 | $1,995.26 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $831.76 Typical High $1,000.00 | Professional | 62 · Two surgeons | $691.83 | $831.76 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $251.19 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $223.87 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,230.27 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $2,187.76 | Facility | None | $478.63 | $1,071.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,778.28 | Professional | None | $977.24 | $1,174.90 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,230.27 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,187.76 | Facility | None | $1,318.26 | $1,584.89 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,548.82 | $1,778.28 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,570.40 Typical High $10,232.93 | Facility | None | $933.25 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,445.44 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $2,137.96 | Professional | None | $794.33 | $1,122.02 | $2,137.96 |
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 $602.56 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $602.56 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $933.25 |
Where Virginia sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 36th of 51
$1,318
AK $4,786UT $776
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.