How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,023 to $21,878Professionalmedian $1,380 · 10th to 90th $1,096 to $1,862
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 $1,445.44 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,445.44 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,445.44 | $1,445.44 |
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 $1,174.90 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,047.13 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $269.15 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $234.42 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,230.27 | $1,380.38 | $1,412.54 |
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 $1,047.13 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,258.93 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,949.84 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,344.23 | Facility | None | $1,445.44 | $1,584.89 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,479.11 | $2,884.03 |
Sentara Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,413.10 | Facility | None | $977.24 | $1,862.09 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,445.44 | $2,884.03 |
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 $851.14 Median $1,148.15 Typical High $2,290.87 | Professional | None | $851.14 | $1,148.15 | $2,290.87 |
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 $645.65 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,000.00 |
Where Virginia sits
The same service costs 6.5 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
$1,413
AK $5,012TX $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.