How much rates vary
Facilitymedian $4,365 · 10th to 90th $676 to $11,220Professionalmedian $631 · 10th to 90th $513 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 $660.69 Median $6,165.95 Typical High $11,481.54 | Facility | None | $660.69 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $4,365.16 | Professional | None | $616.60 | $630.96 | $4,365.16 |
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 $524.81 Median $630.96 Typical High $794.33 | Professional | None | $524.81 | $630.96 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $933.25 Typical High $1,202.26 | Professional | 50 · Both sides | $794.33 | $933.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $398.11 Typical High $501.19 | Professional | 62 · Two surgeons | $331.13 | $398.11 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $4,897.79 | Professional | None | $524.81 | $588.84 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,467.37 | Facility | None | $724.44 | $1,819.70 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $954.99 | Professional | None | $537.03 | $616.60 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $758.58 | Professional | None | $512.86 | $616.60 | $758.58 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | None | $645.65 | $794.33 | $794.33 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $691.83 Typical High $1,023.29 | Facility | None | $630.96 | $691.83 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $446.68 Median $1,819.70 Typical High $10,232.93 | Facility | None | $446.68 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $6,456.54 | Professional | None | $478.63 | $707.95 | $6,456.54 |
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 $446.68 Median $676.08 Typical High $1,071.52 | Professional | None | $446.68 | $676.08 | $1,071.52 |
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 $302.00 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $302.00 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $120.23 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $457.09 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $66.07 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $457.09 |
Where Virginia sits
The same service costs 8.7 times more in Oklahoma 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· 44th of 51
$661
OK $3,631UT $417
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.