How much rates vary
Facilitymedian $4,898 · 10th to 90th $741 to $14,125Professionalmedian $741 · 10th to 90th $589 to $1,047
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 $741.31 Median $5,623.41 Typical High $10,964.78 | Facility | None | $741.31 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,122.02 | Professional | None | $691.83 | $741.31 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $912.01 | Professional | None | $630.96 | $758.58 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | 50 · Both sides | $954.99 | $1,122.02 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $478.63 Typical High $575.44 | Professional | 62 · Two surgeons | $398.11 | $478.63 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $977.24 | Professional | None | $676.08 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $7,079.46 | Facility | None | $512.86 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,047.13 | Professional | None | $616.60 | $676.08 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | None | $602.56 | $724.44 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | None | $870.96 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $851.14 Typical High $1,230.27 | Facility | None | $741.31 | $851.14 | $1,230.27 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $933.25 | Professional | None | $794.33 | $912.01 | $933.25 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,819.70 Typical High $10,964.78 | Facility | None | $616.60 | $1,819.70 | $10,964.78 |
Sentara Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,584.89 | Professional | None | $660.69 | $776.25 | $1,584.89 |
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 $467.74 Median $588.84 Typical High $1,202.26 | Professional | None | $467.74 | $588.84 | $1,202.26 |
6 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 $346.74 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $524.81 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $524.81 |
Where Virginia sits
The same service costs 8.1 times more in Alaska than in Texas. 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
$741
AK $2,754TX $339
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.