How much rates vary
Facilitymedian $2,512 · 10th to 90th $537 to $10,233Professionalmedian $2,089 · 10th to 90th $1,660 to $3,020
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 $2,344.23 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,344.23 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,187.76 | $3,090.30 |
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 $1,659.59 Median $1,905.46 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,905.46 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $389.05 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $346.74 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $346.74 |
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 $1,905.46 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,905.46 | $2,089.30 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,995.26 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,311.31 | Facility | None | $2,187.76 | $2,187.76 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $7,943.28 | Facility | None | $1,288.25 | $2,187.76 | $7,943.28 |
Sentara Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $8,912.51 | Professional | None | $1,584.89 | $2,511.89 | $8,912.51 |
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 $1,258.93 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,258.93 | $2,041.74 | $3,019.95 |
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 $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 53 · Discontinued | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $354.81 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $234.42 |
Where Virginia sits
The same service costs 5.5 times more in Wisconsin than in South Carolina. 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· 33rd of 51
$2,089
WI $7,586SC $1,380
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.