How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,072 to $12,589Professionalmedian $1,175 · 10th to 90th $933 to $1,479
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 $1,445.44 Median $4,786.30 Typical High $14,125.38 | Facility | None | $1,445.44 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,380.38 | $1,445.44 |
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 $933.25 Median $1,096.48 Typical High $1,202.26 | Professional | None | $933.25 | $1,096.48 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $758.58 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $190.55 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $165.96 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,479.11 | $1,698.24 |
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 $1,047.13 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,230.27 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,148.15 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,187.76 | Facility | None | $1,445.44 | $1,445.44 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,548.82 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $6,456.54 | Facility | None | $1,023.29 | $2,137.96 | $6,456.54 |
Sentara Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,348.96 | $2,454.71 |
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 $794.33 Median $1,174.90 Typical High $1,949.84 | Professional | None | $794.33 | $1,174.90 | $1,949.84 |
3 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 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $144.54 |
Where Virginia sits
The same service costs 5.6 times more in Alaska than in New York. 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· 42nd of 51
$1,175
AK $4,786NY $851
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.