How much rates vary
Facilitymedian $5,129 · 10th to 90th $380 to $16,982Professionalmedian $316 · 10th to 90th $263 to $479
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 $316.23 Median $5,495.41 Typical High $14,125.38 | Facility | None | $316.23 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $489.78 | Professional | None | $269.15 | $316.23 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $10,715.19 Typical High $19,952.62 | Facility | None | $4,466.84 | $10,715.19 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $398.11 | Professional | None | $263.03 | $309.03 | $398.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $50.12 Typical High $64.57 | Professional | 80 · Assistant surgeon | $42.66 | $50.12 | $64.57 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $43.65 Typical High $56.23 | Professional | AS · PA/NP assist | $36.31 | $43.65 | $56.23 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $316.23 Typical High $407.38 | Professional | None | $281.84 | $316.23 | $407.38 |
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 $263.03 Median $323.59 Typical High $478.63 | Professional | None | $263.03 | $323.59 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $338.84 | Professional | None | $229.09 | $275.42 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | None | $436.52 | $549.54 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $316.23 Median $380.19 Typical High $512.86 | Facility | None | $316.23 | $380.19 | $512.86 |
Medcost Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Sentara Setting Facility Modifier None Typical Low $257.04 Median $446.68 Typical High $8,912.51 | Facility | None | $257.04 | $446.68 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $676.08 | Professional | None | $263.03 | $363.08 | $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 $229.09 Median $380.19 Typical High $562.34 | Professional | None | $229.09 | $380.19 | $562.34 |
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 $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $51.29 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $190.55 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $31.62 |
Where Virginia sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 40th of 51
$339
AK $871UT $275
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.