How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,230 to $13,490Professionalmedian $1,230 · 10th to 90th $977 to $1,698
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 $1,230.27 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,230.27 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,230.27 | $1,479.11 |
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 $1,023.29 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,230.27 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $912.01 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $234.42 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,122.02 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $5,248.07 | Facility | None | $645.65 | $2,754.23 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,096.48 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,348.96 | Professional | None | $912.01 | $1,096.48 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,862.09 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,995.26 | Facility | None | $1,230.27 | $1,513.56 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $1,412.54 | Professional | None | $977.24 | $1,412.54 | $1,412.54 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,511.89 Typical High $10,232.93 | Facility | None | $933.25 | $2,511.89 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,445.44 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,949.84 | Professional | None | $724.44 | $1,047.13 | $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 $562.34 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $562.34 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $851.14 |
Where Virginia sits
The same service costs 6.3 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· 37th of 51
$1,230
AK $4,365UT $692
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.