How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,230 to $13,490Professionalmedian $1,413 · 10th to 90th $1,148 to $1,995
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 $1,348.96 Median $4,073.80 Typical High $10,000.00 | Facility | None | $1,348.96 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,479.11 | $1,621.81 |
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 $1,445.44 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,445.44 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $1,096.48 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $281.84 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,148.15 | $1,258.93 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $3,019.95 Typical High $7,943.28 | Facility | None | $346.74 | $3,019.95 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,318.26 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,348.96 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,737.80 | $2,238.72 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,398.83 | Facility | None | $1,479.11 | $1,737.80 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,513.56 | Professional | None | $977.24 | $1,148.15 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,000.00 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,584.89 | $3,019.95 |
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 $870.96 Median $1,230.27 Typical High $2,344.23 | Professional | None | $870.96 | $1,230.27 | $2,344.23 |
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 $660.69 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,023.29 |
Where Virginia sits
The same service costs 7.9 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
$1,445
AK $5,248TX $661
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.