How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,259 to $13,804Professionalmedian $1,445 · 10th to 90th $1,175 to $2,042
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 $1,479.11 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,479.11 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,479.11 | $1,659.59 |
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 $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $281.84 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $251.19 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,445.44 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $7,943.28 | Facility | None | $524.81 | $3,019.95 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,348.96 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,454.71 | Facility | None | $1,479.11 | $1,737.80 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,698.24 | $2,187.76 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,659.59 | $3,162.28 |
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 $891.25 Median $1,230.27 Typical High $2,398.83 | Professional | None | $891.25 | $1,230.27 | $2,398.83 |
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 $676.08 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $676.08 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,047.13 |
Where Virginia sits
The same service costs 11.0 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· 37th of 51
$1,479
AK $5,370TX $490
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.