How much rates vary
Facilitymedian $2,138 · 10th to 90th $457 to $6,607Professionalmedian $479 · 10th to 90th $389 to $776
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 $478.63 Median $4,786.30 Typical High $14,125.38 | Facility | None | $478.63 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $691.83 | Professional | None | $478.63 | $501.19 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $575.44 | Professional | None | $380.19 | $457.09 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $63.10 Median $74.13 Typical High $95.50 | Professional | 80 · Assistant surgeon | $63.10 | $74.13 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $53.70 Median $64.57 Typical High $79.43 | Professional | AS · PA/NP assist | $53.70 | $64.57 | $79.43 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $562.34 | Professional | None | $407.38 | $446.68 | $562.34 |
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 $389.05 Median $549.54 Typical High $758.58 | Professional | None | $389.05 | $549.54 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $549.54 | Professional | None | $371.54 | $446.68 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $794.33 | Facility | None | $478.63 | $602.56 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Sentara Setting Facility Modifier None Typical Low $436.52 Median $1,047.13 Typical High $5,128.61 | Facility | None | $436.52 | $1,047.13 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $2,238.72 | Professional | None | $436.52 | $588.84 | $2,238.72 |
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 $380.19 Median $630.96 Typical High $954.99 | Professional | None | $380.19 | $630.96 | $954.99 |
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 $239.88 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $51.29 |
Where Virginia sits
The same service costs 4.1 times more in Wisconsin than in Kentucky. 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· 42nd of 51
$513
WI $1,738KY $427
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.