How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,585 to $15,849Professionalmedian $1,820 · 10th to 90th $1,514 to $2,630
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 $2,041.74 Median $5,370.32 Typical High $14,791.08 | Facility | None | $2,041.74 | $5,370.32 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,737.80 | $1,905.46 | $2,570.40 |
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 $1,548.82 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,862.09 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $2,818.38 Typical High $3,388.44 | Professional | 50 · Both sides | $2,344.23 | $2,818.38 | $3,388.44 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,819.70 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,715.35 Typical High $7,079.46 | Facility | None | $512.86 | $3,715.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,698.24 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,737.80 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,290.87 | $2,884.03 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,090.30 | Facility | None | $1,905.46 | $2,238.72 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,995.26 | $2,089.30 | $2,454.71 |
Sentara Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $11,481.54 | Facility | None | $1,318.26 | $3,467.37 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,584.89 | $1,995.26 | $3,890.45 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,630.27 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,174.90 | $1,548.82 | $3,019.95 |
4 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 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,318.26 | $1,318.26 |
Where Virginia sits
The same service costs 7.8 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· 36th of 51
$1,862
AK $6,761TX $871
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.