How much rates vary
Facilitymedian $4,571 · 10th to 90th $741 to $15,488Professionalmedian $724 · 10th to 90th $589 to $1,023
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 $5,495.41 Typical High $14,125.38 | Facility | None | $741.31 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,023.29 | Professional | None | $676.08 | $741.31 | $1,023.29 |
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 $602.56 Median $724.44 Typical High $870.96 | Professional | None | $602.56 | $724.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,096.48 Typical High $1,318.26 | Professional | 50 · Both sides | $912.01 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $457.09 Typical High $549.54 | Professional | 62 · Two surgeons | $380.19 | $457.09 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $891.25 | Professional | None | $691.83 | $758.58 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,862.09 Typical High $3,162.28 | Facility | None | $512.86 | $1,862.09 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $1,047.13 | Professional | None | $630.96 | $645.65 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $870.96 | Professional | None | $575.44 | $691.83 | $870.96 |
Medcost Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,096.48 | Professional | None | $891.25 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $741.31 Median $891.25 Typical High $1,202.26 | Facility | None | $741.31 | $891.25 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,412.54 | Professional | None | $831.76 | $977.24 | $1,412.54 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $10,715.19 | Facility | None | $616.60 | $2,137.96 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,548.82 | Professional | None | $645.65 | $812.83 | $1,548.82 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,174.90 | Professional | None | $457.09 | $616.60 | $1,174.90 |
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 $331.13 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $512.86 | $512.86 |
Where Virginia sits
The same service costs 7.6 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.