How much rates vary
Facilitymedian $4,786 · 10th to 90th $200 to $25,119Professionalmedian $1,514 · 10th to 90th $148 to $2,754
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 $213.80 Median $4,073.80 Typical High $15,488.17 | Facility | None | $213.80 | $4,073.80 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $1,905.46 Typical High $3,090.30 | Professional | None | $173.78 | $1,905.46 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $26,915.35 Median $35,481.34 Typical High $38,904.51 | Facility | None | $26,915.35 | $35,481.34 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $870.96 Typical High $2,187.76 | Professional | None | $144.54 | $870.96 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $23.44 Median $218.78 Typical High $346.74 | Professional | 80 · Assistant surgeon | $23.44 | $218.78 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $186.21 Typical High $309.03 | Professional | AS · PA/NP assist | $20.42 | $186.21 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $912.01 | Professional | None | $147.91 | $165.96 | $912.01 |
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 $144.54 Median $426.58 Typical High $2,951.21 | Professional | None | $144.54 | $426.58 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $1,949.84 Typical High $2,454.71 | Professional | None | $125.89 | $1,949.84 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $3,162.28 | Facility | None | $173.78 | $281.84 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Sentara Setting Facility Modifier None Typical Low $147.91 Median $912.01 Typical High $11,481.54 | Facility | None | $147.91 | $912.01 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $10,232.93 | Professional | None | $1,737.80 | $2,630.27 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,232.93 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,232.93 | $25,118.86 |
United Setting Professional Modifier None Typical Low $154.88 Median $457.09 Typical High $3,311.31 | Professional | None | $154.88 | $457.09 | $3,311.31 |
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 $87.10 Median $165.96 Typical High $1,174.90 | Professional | 52 · Reduced service | $87.10 | $165.96 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $66.07 Typical High $467.74 | Professional | 53 · Discontinued | $34.67 | $66.07 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $251.19 Typical High $1,737.80 | Professional | 54 · Surgery only | $128.82 | $251.19 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $50.12 Typical High $354.81 | Professional | 55 · Aftercare only | $25.70 | $50.12 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $147.91 Typical High $234.42 | Professional | 56 · Pre-op care only | $17.38 | $147.91 | $234.42 |
Where Virginia sits
The same service costs 11.2 times more in Oklahoma than in Hawaii. 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· 35th of 51
$1,622
OK $2,818HI $251
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.