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 $446.68 Median $5,495.41 Typical High $14,125.38 | Facility | None | $446.68 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | None | $426.58 | $426.58 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $446.68 | Professional | None | $338.84 | $407.38 | $446.68 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $251.19 Typical High $281.84 | Professional | 62 · Two surgeons | $213.80 | $251.19 | $281.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $64.57 Typical High $70.79 | Professional | 80 · Assistant surgeon | $54.95 | $64.57 | $70.79 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $56.23 Typical High $61.66 | Professional | AS · PA/NP assist | $47.86 | $56.23 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $537.03 | Professional | None | $426.58 | $467.74 | $537.03 |
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 $380.19 Median $407.38 Typical High $537.03 | Professional | None | $380.19 | $407.38 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $489.78 | Professional | None | $331.13 | $389.05 | $489.78 |
Medcost Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $676.08 | Facility | None | $446.68 | $446.68 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $478.63 | Professional | None | $269.15 | $389.05 | $478.63 |
Sentara Setting Facility Modifier None Typical Low $302.00 Median $1,584.89 Typical High $5,495.41 | Facility | None | $302.00 | $1,584.89 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $676.08 | Professional | None | $213.80 | $354.81 | $676.08 |
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 $165.96 Median $338.84 Typical High $501.19 | Professional | None | $165.96 | $338.84 | $501.19 |
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 $42.66 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $44.67 |
Where Virginia sits
The same service costs 15.1 times more in New York 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· 38th of 51
$407
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.