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 $295.12 Median $5,495.41 Typical High $14,125.38 | Facility | None | $295.12 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | None | $281.84 | $295.12 | $295.12 |
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 $199.53 Median $234.42 Typical High $257.04 | Professional | None | $199.53 | $234.42 | $257.04 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $147.91 Typical High $162.18 | Professional | 62 · Two surgeons | $123.03 | $147.91 | $162.18 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $37.15 Typical High $40.74 | Professional | 80 · Assistant surgeon | $31.62 | $37.15 | $40.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $32.36 Typical High $35.48 | Professional | AS · PA/NP assist | $27.54 | $32.36 | $35.48 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $549.54 | Professional | None | $426.58 | $478.63 | $549.54 |
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 $257.04 Median $269.15 Typical High $371.54 | Professional | None | $257.04 | $269.15 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $331.13 | Professional | None | $223.87 | $257.04 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $426.58 | Facility | None | $281.84 | $281.84 | $426.58 |
Medcost Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $1,621.81 | Professional | None | $234.42 | $323.59 | $1,621.81 |
Sentara Setting Facility Modifier None Typical Low $223.87 Median $446.68 Typical High $10,232.93 | Facility | None | $223.87 | $446.68 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $407.38 | Professional | None | $213.80 | $251.19 | $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 $162.18 Median $245.47 Typical High $416.87 | Professional | None | $162.18 | $245.47 | $416.87 |
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 $208.93 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $208.93 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $29.51 |
Where Virginia sits
The same service costs 8.1 times more in New York than in Missouri. 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· 43rd of 51
$251
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.