How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,318 to $13,804Professionalmedian $1,585 · 10th to 90th $1,288 to $2,239
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 $1,621.81 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,621.81 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,621.81 | $1,778.28 |
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 $1,348.96 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,584.89 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,202.26 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | 80 · Assistant surgeon | $213.80 | $257.04 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $269.15 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,698.24 | $2,187.76 |
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 $1,318.26 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,445.44 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,479.11 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,778.28 | $2,238.72 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,630.27 | Facility | None | $1,621.81 | $1,905.46 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,737.80 | $1,862.09 | $2,511.89 |
Sentara Setting Facility Modifier None Typical Low $1,122.02 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,122.02 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,412.54 | $1,778.28 | $3,388.44 |
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 $954.99 Median $1,348.96 Typical High $2,570.40 | Professional | None | $954.99 | $1,348.96 | $2,570.40 |
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 $724.44 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $724.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $288.40 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,096.48 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $144.54 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,122.02 | $1,122.02 |
Where Virginia sits
The same service costs 24.5 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· 37th of 51
$1,622
AK $5,754TX $234
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.