How much rates vary
Facilitymedian $832 · 10th to 90th $178 to $4,786Professionalmedian $398 · 10th to 90th $324 to $575
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 $416.87 Median $4,073.80 Typical High $10,000.00 | Facility | None | $416.87 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $676.08 | Professional | None | $363.08 | $416.87 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $489.78 | Professional | None | $338.84 | $398.11 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $64.57 Typical High $75.86 | Professional | 80 · Assistant surgeon | $53.70 | $64.57 | $75.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $56.23 Typical High $67.61 | Professional | AS · PA/NP assist | $46.77 | $56.23 | $67.61 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $457.09 | Professional | None | $346.74 | $389.05 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $2,691.53 | Facility | None | $346.74 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $575.44 | Professional | None | $316.23 | $363.08 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | None | $295.12 | $354.81 | $436.52 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $676.08 | Facility | None | $416.87 | $512.86 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $741.31 | Professional | None | $467.74 | $549.54 | $741.31 |
Sentara Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $2,454.71 | Facility | None | $346.74 | $549.54 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $870.96 | Professional | None | $371.54 | $478.63 | $870.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $660.69 | Professional | None | $245.47 | $346.74 | $660.69 |
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 $181.97 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $41.69 | $41.69 |
Where Virginia sits
The same service costs 4.9 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· 38th of 51
$407
AK $1,445UT $295
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.