How much rates vary
Facilitymedian $2,455 · 10th to 90th $537 to $10,233Professionalmedian $1,660 · 10th to 90th $1,318 to $2,570
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 $1,949.84 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,949.84 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,778.28 | $1,778.28 | $2,570.40 |
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 $1,318.26 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,548.82 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $245.47 Typical High $316.23 | Professional | 80 · Assistant surgeon | $213.80 | $245.47 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $275.42 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $3,235.94 | Professional | None | $2,344.23 | $2,570.40 | $3,235.94 |
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 $1,445.44 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,698.24 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,737.80 | $2,137.96 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,691.53 | Facility | None | $1,778.28 | $1,778.28 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Sentara Setting Facility Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $7,413.10 | Facility | None | $1,230.27 | $2,137.96 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,445.44 Median $2,187.76 Typical High $7,762.47 | Professional | None | $1,445.44 | $2,187.76 | $7,762.47 |
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 $1,230.27 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,949.84 | $2,818.38 |
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 $891.25 Median $891.25 Typical High $977.24 | Professional | 52 · Reduced service | $891.25 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 53 · Discontinued | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $194.98 |
Where Virginia sits
The same service costs 4.7 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· 39th of 51
$1,738
AK $6,166AR $1,318
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.