How much rates vary
Facilitymedian $2,138 · 10th to 90th $324 to $10,000Professionalmedian $331 · 10th to 90th $263 to $513
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 $346.74 Median $5,495.41 Typical High $14,125.38 | Facility | None | $346.74 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $776.25 | Professional | None | $316.23 | $338.84 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $17,378.01 | Facility | None | $8,912.51 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $389.05 | Professional | None | $263.03 | $309.03 | $389.05 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $194.98 Typical High $245.47 | Professional | 62 · Two surgeons | $162.18 | $194.98 | $245.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $50.12 Typical High $64.57 | Professional | 80 · Assistant surgeon | $42.66 | $50.12 | $64.57 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $43.65 Typical High $54.95 | Professional | AS · PA/NP assist | $36.31 | $43.65 | $54.95 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $407.38 | Professional | None | $295.12 | $331.13 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $3,019.95 | Facility | None | $512.86 | $1,174.90 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $501.19 | Professional | None | $263.03 | $363.08 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $363.08 | Professional | None | $245.47 | $295.12 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $537.03 | Professional | None | $426.58 | $537.03 | $537.03 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $524.81 | Facility | None | $323.59 | $407.38 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $933.25 Typical High $5,128.61 | Facility | None | $269.15 | $933.25 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $2,187.76 | Professional | None | $295.12 | $407.38 | $2,187.76 |
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 $251.19 Median $416.87 Typical High $602.56 | Professional | None | $251.19 | $416.87 | $602.56 |
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 $158.49 Median $158.49 Typical High $173.78 | Professional | 52 · Reduced service | $158.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | 54 · Surgery only | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $34.67 |
Where Virginia sits
The same service costs 3.9 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
$347
WI $1,175NY $302
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.