How much rates vary
Facilitymedian $4,365 · 10th to 90th $437 to $11,220Professionalmedian $372 · 10th to 90th $282 to $617
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 $5,248.07 Typical High $14,125.38 | Facility | None | $436.52 | $5,248.07 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $2,041.74 | Professional | None | $257.04 | $346.74 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $446.68 | Professional | None | $295.12 | $346.74 | $446.68 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $218.78 Typical High $281.84 | Professional | 62 · Two surgeons | $181.97 | $218.78 | $281.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $56.23 Typical High $70.79 | Professional | 80 · Assistant surgeon | $46.77 | $56.23 | $70.79 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $48.98 Typical High $63.10 | Professional | AS · PA/NP assist | $40.74 | $48.98 | $63.10 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $4,466.84 | Professional | None | $302.00 | $331.13 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $4,365.16 | Facility | None | $524.81 | $2,290.87 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $575.44 | Professional | None | $281.84 | $389.05 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $389.05 | Professional | None | $263.03 | $316.23 | $389.05 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $537.03 Typical High $575.44 | Facility | None | $346.74 | $537.03 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Sentara Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $10,232.93 | Facility | None | $323.59 | $1,445.44 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $6,025.60 | Professional | None | $323.59 | $467.74 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $676.08 | Professional | None | $263.03 | $467.74 | $676.08 |
5 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 52 · Reduced service Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $128.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $51.29 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $34.67 |
Where Virginia sits
The same service costs 10.0 times more in Oklahoma 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· 48th of 51
$380
OK $2,884NY $288
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.