How much rates vary
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 $512.86 Median $5,495.41 Typical High $14,125.38 | Facility | None | $512.86 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $3,235.94 | Professional | None | $436.52 | $501.19 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $11,220.18 Typical High $12,589.25 | Facility | None | $8,511.38 | $11,220.18 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $676.08 | Professional | None | $446.68 | $524.81 | $676.08 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $331.13 Typical High $426.58 | Professional | 62 · Two surgeons | $281.84 | $331.13 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $85.11 Typical High $107.15 | Professional | 80 · Assistant surgeon | $72.44 | $85.11 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $74.13 Typical High $93.33 | Professional | AS · PA/NP assist | $63.10 | $74.13 | $93.33 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $741.31 | Professional | None | $537.03 | $602.56 | $741.31 |
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 $407.38 Median $467.74 Typical High $741.31 | Professional | None | $407.38 | $467.74 | $741.31 |
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 Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $660.69 | Facility | None | $436.52 | $436.52 | $660.69 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Sentara Setting Facility Modifier None Typical Low $436.52 Median $1,737.80 Typical High $5,623.41 | Facility | None | $436.52 | $1,737.80 | $5,623.41 |
Sentara Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $7,413.10 | Professional | None | $407.38 | $691.83 | $7,413.10 |
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 $316.23 Median $512.86 Typical High $794.33 | Professional | None | $316.23 | $512.86 | $794.33 |
3 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 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $51.29 |
Where Virginia sits
The same service costs 7.1 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· 41st of 51
$562
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.