How much rates vary
Facilitymedian $2,630 · 10th to 90th $427 to $10,965Professionalmedian $447 · 10th to 90th $269 to $832
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 $549.54 Median $1,023.29 Typical High $8,317.64 | Facility | None | $549.54 | $1,023.29 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $588.84 Typical High $1,096.48 | Professional | None | $338.84 | $588.84 | $1,096.48 |
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 $263.03 Median $389.05 Typical High $549.54 | Professional | None | $263.03 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $588.84 Typical High $831.76 | Professional | 50 · Both sides | $389.05 | $588.84 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $245.47 Typical High $346.74 | Professional | 62 · Two surgeons | $162.18 | $245.47 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $3,019.95 | Professional | None | $245.47 | $269.15 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $501.19 Typical High $2,570.40 | Facility | None | $229.09 | $501.19 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $776.25 | Professional | None | $263.03 | $489.78 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $478.63 Typical High $588.84 | Professional | None | $234.42 | $478.63 | $588.84 |
Medcost Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $776.25 | Professional | None | $616.60 | $776.25 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $1,174.90 | Facility | None | $501.19 | $630.96 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Sentara Setting Facility Modifier None Typical Low $316.23 Median $1,698.24 Typical High $10,232.93 | Facility | None | $316.23 | $1,698.24 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $10,000.00 | Professional | None | $446.68 | $776.25 | $10,000.00 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $295.12 Median $602.56 Typical High $1,000.00 | Professional | None | $295.12 | $602.56 | $1,000.00 |
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 $165.96 Median $251.19 Typical High $363.08 | Professional | 52 · Reduced service | $165.96 | $251.19 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $102.33 Typical High $144.54 | Professional | 53 · Discontinued | $67.61 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $537.03 | Professional | 54 · Surgery only | $251.19 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $75.86 Typical High $109.65 | Professional | 55 · Aftercare only | $50.12 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $50.12 Typical High $72.44 | Professional | 56 · Pre-op care only | $33.88 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $501.19 |
Where Virginia sits
The same service costs 4.1 times more in Wisconsin 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· 44th of 51
$490
WI $1,549TX $380
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.