How much rates vary
Facilitymedian $4,074 · 10th to 90th $389 to $12,303Professionalmedian $263 · 10th to 90th $219 to $331
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 $275.42 Median $5,495.41 Typical High $14,125.38 | Facility | None | $275.42 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $223.87 Median $263.03 Typical High $316.23 | Professional | None | $223.87 | $263.03 | $316.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $141.25 Median $165.96 Typical High $199.53 | Professional | 62 · Two surgeons | $141.25 | $165.96 | $199.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $42.66 Typical High $51.29 | Professional | 80 · Assistant surgeon | $35.48 | $42.66 | $51.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $37.15 Typical High $44.67 | Professional | AS · PA/NP assist | $31.62 | $37.15 | $44.67 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $295.12 | Professional | None | $234.42 | $257.04 | $295.12 |
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 $229.09 Median $251.19 Typical High $354.81 | Professional | None | $229.09 | $251.19 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $398.11 | Professional | None | $204.17 | $234.42 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | None | $338.84 | $436.52 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $457.09 | Facility | None | $275.42 | $323.59 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $323.59 | Professional | None | $223.87 | $245.47 | $323.59 |
Sentara Setting Facility Modifier None Typical Low $234.42 Median $1,258.93 Typical High $6,165.95 | Facility | None | $234.42 | $1,258.93 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $407.38 | Professional | None | $239.88 | $269.15 | $407.38 |
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 $186.21 Median $229.09 Typical High $407.38 | Professional | None | $186.21 | $229.09 | $407.38 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 53 · Discontinued | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Where Virginia sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$263
AK $977UT $195
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.