How much rates vary
Facilitymedian $3,388 · 10th to 90th $646 to $9,550Professionalmedian $646 · 10th to 90th $525 to $891
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 $645.65 Median $5,370.32 Typical High $14,125.38 | Facility | None | $645.65 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $645.65 Typical High $891.25 | Professional | None | $616.60 | $645.65 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $794.33 | Professional | None | $549.54 | $660.69 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,000.00 Typical High $1,202.26 | Professional | 50 · Both sides | $831.76 | $1,000.00 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $416.87 Typical High $501.19 | Professional | 62 · Two surgeons | $346.74 | $416.87 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $851.14 | Professional | None | $588.84 | $645.65 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $3,090.30 | Facility | None | $524.81 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $912.01 | Professional | None | $537.03 | $602.56 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $794.33 | Professional | None | $537.03 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $870.96 | Professional | None | $707.95 | $870.96 | $870.96 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $707.95 Typical High $1,071.52 | Facility | None | $645.65 | $707.95 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | None | $660.69 | $660.69 | $676.08 |
Sentara Setting Facility Modifier None Typical Low $501.19 Median $1,737.80 Typical High $8,709.64 | Facility | None | $501.19 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,380.38 | Professional | None | $562.34 | $691.83 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $1,047.13 | Professional | None | $398.11 | $524.81 | $1,047.13 |
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 $309.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $457.09 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $457.09 |
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· 35th of 51
$646
AK $2,399TX $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.