How much rates vary
Facilitymedian $3,236 · 10th to 90th $447 to $10,000Professionalmedian $407 · 10th to 90th $331 to $501
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 $446.68 Median $4,786.30 Typical High $10,000.00 | Facility | None | $446.68 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $446.68 | Professional | None | $416.87 | $436.52 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $501.19 | Professional | None | $354.81 | $416.87 | $501.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $223.87 Median $263.03 Typical High $316.23 | Professional | 62 · Two surgeons | $223.87 | $263.03 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $467.74 | Professional | None | $354.81 | $398.11 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,479.11 Typical High $2,691.53 | Facility | None | $478.63 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $549.54 | Professional | None | $338.84 | $398.11 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $602.56 | Professional | None | $354.81 | $416.87 | $602.56 |
Medcost Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | None | $416.87 | $524.81 | $524.81 |
Medcost Setting Facility Modifier None Typical Low $416.87 Median $446.68 Typical High $676.08 | Facility | None | $416.87 | $446.68 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $562.34 | Professional | None | $380.19 | $426.58 | $562.34 |
Sentara Setting Facility Modifier None Typical Low $323.59 Median $1,445.44 Typical High $8,709.64 | Facility | None | $323.59 | $1,445.44 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $616.60 | Professional | None | $331.13 | $407.38 | $616.60 |
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 $269.15 Median $354.81 Typical High $602.56 | Professional | None | $269.15 | $354.81 | $602.56 |
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 $208.93 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $309.03 |
Where Virginia sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$407
AK $1,549UT $302
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.