How much rates vary
Facilitymedian $2,692 · 10th to 90th $490 to $10,965Professionalmedian $525 · 10th to 90th $324 to $1,000
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 $1,698.24 Typical High $9,332.54 | Facility | None | $645.65 | $1,698.24 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $758.58 Typical High $1,380.38 | Professional | None | $407.38 | $758.58 | $1,380.38 |
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 $323.59 Median $457.09 Typical High $645.65 | Professional | None | $323.59 | $457.09 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $691.83 Typical High $977.24 | Professional | 50 · Both sides | $467.74 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $199.53 Median $288.40 Typical High $407.38 | Professional | 62 · Two surgeons | $199.53 | $288.40 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $3,019.95 | Professional | None | $302.00 | $331.13 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $501.19 Typical High $2,570.40 | Facility | None | $257.04 | $501.19 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $912.01 | Professional | None | $323.59 | $562.34 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $575.44 Typical High $707.95 | Professional | None | $288.40 | $575.44 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | None | $758.58 | $954.99 | $954.99 |
Medcost Setting Facility Modifier None Typical Low $616.60 Median $758.58 Typical High $1,412.54 | Facility | None | $616.60 | $758.58 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Sentara Setting Facility Modifier None Typical Low $389.05 Median $1,737.80 Typical High $10,232.93 | Facility | None | $389.05 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $537.03 Median $933.25 Typical High $10,000.00 | Professional | None | $537.03 | $933.25 | $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 $346.74 Median $724.44 Typical High $1,174.90 | Professional | None | $346.74 | $724.44 | $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 $204.17 Median $309.03 Typical High $426.58 | Professional | 52 · Reduced service | $204.17 | $309.03 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $123.03 Typical High $173.78 | Professional | 53 · Discontinued | $81.28 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $467.74 Typical High $645.65 | Professional | 54 · Surgery only | $309.03 | $467.74 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $93.33 Typical High $128.82 | Professional | 55 · Aftercare only | $61.66 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $61.66 Typical High $85.11 | Professional | 56 · Pre-op care only | $40.74 | $61.66 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $436.52 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $288.40 | $436.52 | $602.56 |
Where Virginia sits
The same service costs 4.3 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
$575
WI $1,862TX $437
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.