How much rates vary
Facilitymedian $4,677 · 10th to 90th $912 to $11,220Professionalmedian $955 · 10th to 90th $776 to $1,514
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 $954.99 Median $5,370.32 Typical High $14,125.38 | Facility | None | $954.99 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $3,981.07 | Professional | None | $891.25 | $954.99 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,202.26 | Professional | None | $776.25 | $933.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $588.84 Typical High $758.58 | Professional | 62 · Two surgeons | $489.78 | $588.84 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $6,918.31 | Professional | None | $812.83 | $912.01 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,630.27 Typical High $5,128.61 | Facility | None | $524.81 | $2,630.27 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,445.44 | Professional | None | $812.83 | $954.99 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,096.48 | Professional | None | $741.31 | $870.96 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,348.96 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,548.82 | Facility | None | $954.99 | $1,202.26 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Sentara Setting Facility Modifier None Typical Low $776.25 Median $2,238.72 Typical High $10,232.93 | Facility | None | $776.25 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $6,025.60 | Professional | None | $831.76 | $1,096.48 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,698.24 | Professional | None | $691.83 | $1,122.02 | $1,698.24 |
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 $446.68 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $660.69 |
Where Virginia sits
The same service costs 5.9 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· 42nd of 51
$977
AK $3,467TX $589
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.