How much rates vary
Facilitymedian $4,074 · 10th to 90th $692 to $12,589Professionalmedian $372 · 10th to 90th $263 to $724
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 $691.83 Median $4,365.16 Typical High $14,125.38 | Facility | None | $691.83 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $812.83 | Professional | None | $616.60 | $691.83 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $380.19 | Professional | None | $263.03 | $309.03 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $467.74 Typical High $562.34 | Professional | 50 · Both sides | $389.05 | $467.74 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $165.96 Median $194.98 Typical High $239.88 | Professional | 62 · Two surgeons | $165.96 | $194.98 | $239.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $50.12 Typical High $60.26 | Professional | 80 · Assistant surgeon | $42.66 | $50.12 | $60.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $43.65 Typical High $52.48 | Professional | AS · PA/NP assist | $36.31 | $43.65 | $52.48 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $616.60 | Professional | None | $537.03 | $602.56 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $6,760.83 | Facility | None | $707.95 | $1,659.59 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $933.25 | Professional | None | $537.03 | $616.60 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $851.14 | Professional | None | $562.34 | $676.08 | $851.14 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $776.25 Typical High $1,047.13 | Facility | None | $691.83 | $776.25 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $870.96 | Professional | None | $562.34 | $724.44 | $870.96 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,621.81 Typical High $10,964.78 | Facility | None | $501.19 | $1,621.81 | $10,964.78 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,479.11 | Professional | None | $489.78 | $707.95 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,918.31 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,918.31 | $17,378.01 |
United Setting Professional Modifier None Typical Low $165.96 Median $331.13 Typical High $630.96 | Professional | None | $165.96 | $331.13 | $630.96 |
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 $309.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $69.18 |
Where Virginia sits
The same service costs 10.0 times more in Alaska 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· 46th of 51
$380
AK $2,455KY $245
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.