How much rates vary
Facilitymedian $2,138 · 10th to 90th $537 to $10,233Professionalmedian $851 · 10th to 90th $676 to $1,349
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 $912.01 Median $5,495.41 Typical High $14,125.38 | Facility | None | $912.01 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,230.27 | Professional | None | $851.14 | $870.96 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,023.29 | Professional | None | $676.08 | $812.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $162.18 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $112.20 Typical High $141.25 | Professional | AS · PA/NP assist | $93.33 | $112.20 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,047.13 | Professional | None | $758.58 | $851.14 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $794.33 Typical High $3,019.95 | Facility | None | $512.86 | $794.33 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,348.96 | Professional | None | $676.08 | $954.99 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $954.99 | Professional | None | $645.65 | $776.25 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Facility | None | $851.14 | $1,000.00 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $707.95 Median $1,479.11 Typical High $5,128.61 | Facility | None | $707.95 | $1,479.11 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $3,801.89 | Professional | None | $724.44 | $1,000.00 | $3,801.89 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,659.59 | Professional | None | $676.08 | $1,122.02 | $1,659.59 |
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 $426.58 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | 53 · Discontinued | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $91.20 |
Where Virginia sits
The same service costs 3.8 times more in Wisconsin than in New York. 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· 43rd of 51
$871
WI $2,951NY $776
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.