How much rates vary
Facilitymedian $2,754 · 10th to 90th $537 to $10,233Professionalmedian $3,162 · 10th to 90th $2,344 to $4,365
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 $2,951.21 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,951.21 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,754.23 | $2,951.21 | $3,981.07 |
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 $2,818.38 Median $3,311.31 Typical High $4,168.69 | Professional | None | $2,818.38 | $3,311.31 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $537.03 Typical High $676.08 | Professional | 80 · Assistant surgeon | $457.09 | $537.03 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $467.74 Typical High $588.84 | Professional | AS · PA/NP assist | $398.11 | $467.74 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $3,162.28 Median $3,467.37 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,467.37 | $4,365.16 |
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 $2,398.83 Median $2,630.27 Typical High $4,073.80 | Professional | None | $2,398.83 | $2,630.27 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,995.26 | $2,398.83 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,466.84 | Facility | None | $2,951.21 | $2,951.21 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Sentara Setting Facility Modifier None Typical Low $1,318.26 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,318.26 | $2,398.83 | $9,772.37 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $3,019.95 Typical High $10,232.93 | Professional | None | $1,862.09 | $3,019.95 | $10,232.93 |
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 $1,548.82 Median $2,454.71 Typical High $3,548.13 | Professional | None | $1,548.82 | $2,454.71 | $3,548.13 |
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 $1,380.38 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,380.38 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $549.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,041.74 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $275.42 | $295.12 | $295.12 |
Where Virginia sits
The same service costs 5.6 times more in Alaska 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· 26th of 51
$3,090
AK $9,550SC $1,698
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.