How much rates vary
Facilitymedian $4,074 · 10th to 90th $479 to $12,303Professionalmedian $407 · 10th to 90th $347 to $525
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 $436.52 Median $5,495.41 Typical High $14,125.38 | Facility | None | $436.52 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $354.81 Median $416.87 Typical High $501.19 | Professional | None | $354.81 | $416.87 | $501.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $263.03 Typical High $316.23 | Professional | 62 · Two surgeons | $223.87 | $263.03 | $316.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $67.61 Typical High $79.43 | Professional | 80 · Assistant surgeon | $56.23 | $67.61 | $79.43 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $57.54 Typical High $69.18 | Professional | AS · PA/NP assist | $50.12 | $57.54 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | None | $371.54 | $407.38 | $467.74 |
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 $363.08 Median $389.05 Typical High $562.34 | Professional | None | $363.08 | $389.05 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $630.96 | Professional | None | $323.59 | $371.54 | $630.96 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | None | $537.03 | $691.83 | $691.83 |
Medcost Setting Facility Modifier None Typical Low $436.52 Median $512.86 Typical High $707.95 | Facility | None | $436.52 | $512.86 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $602.56 | Professional | None | $416.87 | $416.87 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $371.54 Median $1,288.25 Typical High $6,165.95 | Facility | None | $371.54 | $1,288.25 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $645.65 | Professional | None | $380.19 | $426.58 | $645.65 |
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 $295.12 Median $363.08 Typical High $645.65 | Professional | None | $295.12 | $363.08 | $645.65 |
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 $323.59 Median $323.59 Typical High $331.13 | Professional | 54 · Surgery only | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Where Virginia sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 37th of 51
$417
AK $1,514NJ $347
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.