How much rates vary
Facilitymedian $3,467 · 10th to 90th $550 to $10,233Professionalmedian $3,890 · 10th to 90th $3,090 to $5,888
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 $3,801.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,801.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $5,128.61 | Professional | None | $3,630.78 | $3,801.89 | $5,128.61 |
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 $3,090.30 Median $3,715.35 Typical High $4,677.35 | Professional | None | $3,090.30 | $3,715.35 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $588.84 Typical High $758.58 | Professional | 80 · Assistant surgeon | $501.19 | $588.84 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $524.81 Typical High $660.69 | Professional | AS · PA/NP assist | $436.52 | $524.81 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $3,548.13 Median $3,890.45 Typical High $4,897.79 | Professional | None | $3,548.13 | $3,890.45 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $4,265.80 Typical High $5,888.44 | Professional | None | $3,162.28 | $4,265.80 | $5,888.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,019.95 Median $3,630.78 Typical High $4,466.84 | Professional | None | $3,019.95 | $3,630.78 | $4,466.84 |
Medcost Setting Facility Modifier None Typical Low $3,801.89 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,801.89 | $4,677.35 | $6,309.57 |
Medcost Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $10,232.93 | Facility | None | $1,737.80 | $3,890.45 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $2,570.40 Median $4,466.84 Typical High $8,912.51 | Professional | None | $2,570.40 | $4,466.84 | $8,912.51 |
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 $3,090.30 Median $4,897.79 Typical High $7,585.78 | Professional | None | $3,090.30 | $4,897.79 | $7,585.78 |
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 $1,905.46 Median $1,905.46 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 53 · Discontinued | $758.58 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $416.87 |
Where Virginia sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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· 32nd of 51
$3,890
AK $13,490AR $1,820
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.