How much rates vary
Facilitymedian $4,365 · 10th to 90th $575 to $12,589Professionalmedian $457 · 10th to 90th $363 to $933
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 $7,585.78 Typical High $16,218.10 | Facility | None | $478.63 | $7,585.78 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $7,079.46 | Professional | None | $457.09 | $478.63 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $7,413.10 Typical High $14,125.38 | Facility | None | $3,162.28 | $7,413.10 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $537.03 | Professional | None | $354.81 | $426.58 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $645.65 Typical High $812.83 | Professional | 50 · Both sides | $537.03 | $645.65 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | 62 · Two surgeons | $223.87 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $69.18 Typical High $87.10 | Professional | 80 · Assistant surgeon | $57.54 | $69.18 | $87.10 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $60.26 Typical High $72.44 | Professional | AS · PA/NP assist | $50.12 | $60.26 | $72.44 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $537.03 | Professional | None | $380.19 | $426.58 | $537.03 |
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 $354.81 Median $562.34 Typical High $954.99 | Professional | None | $354.81 | $562.34 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | None | $331.13 | $398.11 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,202.26 | Professional | None | $912.01 | $1,202.26 | $1,202.26 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $891.25 | Facility | None | $457.09 | $741.31 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $1,288.25 Typical High $6,165.95 | Facility | None | $426.58 | $1,288.25 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $2,187.76 | Professional | None | $416.87 | $758.58 | $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 $380.19 Median $707.95 Typical High $1,023.29 | Professional | None | $380.19 | $707.95 | $1,023.29 |
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 $229.09 Median $229.09 Typical High $239.88 | Professional | 52 · Reduced service | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $47.86 |
Where Virginia sits
The same service costs 3.7 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· 44th of 51
$589
WI $1,622NY $437
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.