How much rates vary
Facilitymedian $794 · 10th to 90th $148 to $5,623Professionalmedian $200 · 10th to 90th $158 to $275
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 $199.53 Median $4,786.30 Typical High $10,000.00 | Facility | None | $199.53 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $269.15 | Professional | None | $181.97 | $199.53 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | None | $165.96 | $199.53 | $239.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $104.71 Median $123.03 Typical High $151.36 | Professional | 62 · Two surgeons | $104.71 | $123.03 | $151.36 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $31.62 Typical High $37.15 | Professional | 80 · Assistant surgeon | $26.30 | $31.62 | $37.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $26.92 Typical High $33.11 | Professional | AS · PA/NP assist | $22.91 | $26.92 | $33.11 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | None | $186.21 | $204.17 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $2,691.53 | Facility | None | $512.86 | $933.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $275.42 | Professional | None | $165.96 | $177.83 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $239.88 | Professional | None | $158.49 | $190.55 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $316.23 | Professional | None | $251.19 | $316.23 | $316.23 |
Medcost Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $331.13 | Facility | None | $199.53 | $234.42 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $218.78 | Professional | None | $186.21 | $208.93 | $218.78 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $371.54 Typical High $10,232.93 | Facility | None | $147.91 | $371.54 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $426.58 | Professional | None | $147.91 | $218.78 | $426.58 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $323.59 | Professional | None | $123.03 | $162.18 | $323.59 |
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 $91.20 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $36.31 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $19.95 |
Where Virginia sits
The same service costs 12.2 times more in New York than in Florida. 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.
Physician feeFacility fee
NY $3,336FL $274
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.