How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,288 to $13,804Professionalmedian $1,549 · 10th to 90th $1,230 to $2,138
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 $1,548.82 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,548.82 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,548.82 | $1,862.09 |
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 $1,288.25 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,548.82 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,174.90 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $245.47 Typical High $295.12 | Professional | 80 · Assistant surgeon | $204.17 | $245.47 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $257.04 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,380.38 | $1,548.82 | $2,041.74 |
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 $1,288.25 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,380.38 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,412.54 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,737.80 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,511.89 | Facility | None | $1,548.82 | $1,819.70 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,698.24 | $1,819.70 | $2,511.89 |
Sentara Setting Facility Modifier None Typical Low $1,071.52 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,071.52 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,778.28 | $3,235.94 |
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 $912.01 Median $1,288.25 Typical High $2,511.89 | Professional | None | $912.01 | $1,288.25 | $2,511.89 |
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 $707.95 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,071.52 |
Where Virginia sits
The same service costs 7.2 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· 36th of 51
$1,549
AK $5,495TX $759
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.