How much rates vary
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 $1,995.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,995.26 | $5,495.41 | $14,125.38 |
Aetna 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 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $8,128.31 Typical High $14,125.38 | Facility | None | $3,162.28 | $8,128.31 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $776.25 | Professional | None | $602.56 | $707.95 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $125.89 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $109.65 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,495.41 | Facility | None | $501.19 | $1,174.90 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $660.69 | Professional | None | $436.52 | $562.34 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,884.03 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,019.95 | Facility | None | $1,995.26 | $1,995.26 | $3,019.95 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $10,232.93 | Facility | None | $1,288.25 | $2,290.87 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $4,265.80 Typical High $10,232.93 | Professional | None | $1,288.25 | $4,265.80 | $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 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $199.53 |
Where Virginia sits
The same service costs 117.5 times more in Nebraska 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· 48th of 51
$724
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.