How much rates vary
Facilitymedian $2,188 · 10th to 90th $589 to $10,233Professionalmedian $1,122 · 10th to 90th $891 to $1,778
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 $1,202.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,148.15 | $1,621.81 |
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 $891.25 Median $1,071.52 Typical High $1,348.96 | Professional | None | $891.25 | $1,071.52 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $141.25 | $169.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $147.91 Typical High $186.21 | Professional | AS · PA/NP assist | $123.03 | $147.91 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,122.02 | $1,380.38 |
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 $891.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $891.25 | $1,288.25 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,258.93 | Professional | None | $851.14 | $1,023.29 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,819.70 | Facility | None | $1,122.02 | $1,318.26 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $1,737.80 Typical High $5,128.61 | Facility | None | $912.01 | $1,737.80 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $4,570.88 | Professional | None | $954.99 | $1,318.26 | $4,570.88 |
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 $891.25 Median $1,479.11 Typical High $2,187.76 | Professional | None | $891.25 | $1,479.11 | $2,187.76 |
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 $562.34 Median $562.34 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $120.23 |
Where Virginia sits
The same service costs 3.7 times more in Alaska 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· 41st of 51
$1,148
AK $3,802NY $1,023
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.