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 $218.78 Median $5,495.41 Typical High $14,125.38 | Facility | None | $218.78 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $426.58 | Professional | None | $213.80 | $213.80 | $426.58 |
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 $173.78 Median $204.17 Typical High $257.04 | Professional | None | $173.78 | $204.17 | $257.04 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $109.65 Median $128.82 Typical High $162.18 | Professional | 62 · Two surgeons | $109.65 | $128.82 | $162.18 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $32.36 Typical High $40.74 | Professional | 80 · Assistant surgeon | $27.54 | $32.36 | $40.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $23.99 Median $28.18 Typical High $35.48 | Professional | AS · PA/NP assist | $23.99 | $28.18 | $35.48 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $436.52 | Professional | None | $302.00 | $331.13 | $436.52 |
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 $190.55 Median $208.93 Typical High $354.81 | Professional | None | $190.55 | $208.93 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $275.42 | Professional | None | $186.21 | $223.87 | $275.42 |
Medcost Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $323.59 | Facility | None | $213.80 | $213.80 | $323.59 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Sentara Setting Facility Modifier None Typical Low $169.82 Median $1,288.25 Typical High $5,495.41 | Facility | None | $169.82 | $1,288.25 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $2,187.76 | Professional | None | $147.91 | $251.19 | $2,187.76 |
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 $107.15 Median $213.80 Typical High $323.59 | Professional | None | $107.15 | $213.80 | $323.59 |
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 $158.49 Median $158.49 Typical High $165.96 | Professional | 54 · Surgery only | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $21.88 |
Where Virginia sits
The same service costs 10.5 times more in North Dakota than in Kentucky. 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
$219
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.