How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,622 to $13,490Professionalmedian $2,089 · 10th to 90th $1,738 to $3,311
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 $2,089.30 Median $7,079.46 Typical High $14,125.38 | Facility | None | $2,089.30 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,949.84 | $2,089.30 | $4,168.69 |
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 $1,737.80 Median $2,089.30 Typical High $2,691.53 | Professional | None | $1,737.80 | $2,089.30 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $3,162.28 Typical High $3,981.07 | Professional | 50 · Both sides | $2,630.27 | $3,162.28 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $338.84 Typical High $426.58 | Professional | 80 · Assistant surgeon | $281.84 | $338.84 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $371.54 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,819.70 | $2,041.74 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,019.95 Typical High $5,754.40 | Facility | None | $512.86 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,089.30 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,905.46 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,398.83 | $3,019.95 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,388.44 | Facility | None | $2,089.30 | $2,511.89 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Sentara Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $10,232.93 | Facility | None | $1,412.54 | $2,754.23 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $8,511.38 | Professional | None | $1,737.80 | $2,454.71 | $8,511.38 |
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 $1,513.56 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,513.56 | $2,454.71 | $3,715.35 |
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 $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $389.05 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,479.11 |
Where Virginia sits
The same service costs 6.9 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
$2,188
AK $7,586TX $1,096
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.