How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,259 to $15,849Professionalmedian $1,862 · 10th to 90th $1,148 to $2,455
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 $5,888.44 Typical High $14,125.38 | Facility | None | $1,348.96 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,737.80 | $2,041.74 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $398.11 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $281.84 Typical High $346.74 | Professional | AS · PA/NP assist | $239.88 | $281.84 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $5,623.41 Median $6,918.31 Typical High $8,709.64 | Professional | None | $5,623.41 | $6,918.31 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,466.84 Typical High $8,912.51 | Facility | None | $512.86 | $4,466.84 | $8,912.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,089.30 | Facility | None | $1,348.96 | $1,348.96 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Sentara Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $11,481.54 | Facility | None | $1,000.00 | $2,570.40 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $3,235.94 | Professional | None | $933.25 | $1,445.44 | $3,235.94 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,290.87 | Professional | None | $870.96 | $1,230.27 | $2,290.87 |
5 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 $602.56 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $134.90 | $134.90 |
Where Virginia sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 23rd of 51
$1,950
TX $5,754KY $977
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.