How much rates vary
Facilitymedian $3,715 · 10th to 90th $513 to $10,233Professionalmedian $501 · 10th to 90th $355 to $776
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 $524.81 Median $5,495.41 Typical High $14,125.38 | Facility | None | $524.81 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $549.54 | Professional | None | $478.63 | $512.86 | $549.54 |
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 $416.87 Median $501.19 Typical High $645.65 | Professional | None | $416.87 | $501.19 | $645.65 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $316.23 Typical High $407.38 | Professional | 62 · Two surgeons | $263.03 | $316.23 | $407.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $79.43 Typical High $102.33 | Professional | 80 · Assistant surgeon | $67.61 | $79.43 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $70.79 Typical High $89.13 | Professional | AS · PA/NP assist | $58.88 | $70.79 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $8,511.38 | Professional | None | $436.52 | $478.63 | $8,511.38 |
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 $316.23 Median $446.68 Typical High $776.25 | Professional | None | $316.23 | $446.68 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $537.03 | Professional | None | $363.08 | $436.52 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | None | $371.54 | $457.09 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $831.76 | Facility | None | $363.08 | $363.08 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $281.84 Median $1,659.59 Typical High $8,709.64 | Facility | None | $281.84 | $1,659.59 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $4,570.88 | Professional | None | $281.84 | $501.19 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $851.14 | Professional | None | $257.04 | $416.87 | $851.14 |
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 $245.47 Median $257.04 Typical High $263.03 | Professional | 52 · Reduced service | $245.47 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $97.72 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $398.11 | Professional | 54 · Surgery only | $363.08 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $52.48 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $52.48 |
Where Virginia sits
The same service costs 5.2 times more in Alaska 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· 39th of 51
$513
AK $1,820KY $347
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.