How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,047 to $11,220Professionalmedian $1,413 · 10th to 90th $1,047 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 $1,737.80 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,737.80 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $4,168.69 | Professional | None | $1,047.13 | $1,737.80 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,513.56 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,238.72 Typical High $2,630.27 | Professional | 50 · Both sides | $1,862.09 | $2,238.72 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $933.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $794.33 | $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 $245.47 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,380.38 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,238.72 Typical High $4,168.69 | Facility | None | $724.44 | $2,238.72 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,288.25 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,318.26 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,513.56 | $1,862.09 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,238.72 | Facility | None | $1,047.13 | $1,445.44 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,290.87 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $6,456.54 | Professional | None | $1,023.29 | $1,445.44 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,041.74 | Professional | None | $870.96 | $1,230.27 | $2,041.74 |
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 $524.81 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $524.81 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $208.93 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $794.33 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $158.49 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $104.71 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $741.31 | $1,230.27 | $1,230.27 |
Where Virginia sits
The same service costs 7.1 times more in Alaska than in Utah. 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
$1,479
AK $5,370UT $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.