How much rates vary
Facilitymedian $4,266 · 10th to 90th $776 to $10,965Professionalmedian $912 · 10th to 90th $646 to $1,259
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 $1,122.02 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,122.02 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $3,388.44 | Professional | None | $645.65 | $1,122.02 | $3,388.44 |
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 $794.33 Median $954.99 Typical High $1,122.02 | Professional | None | $794.33 | $954.99 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,445.44 Typical High $1,698.24 | Professional | 50 · Both sides | $1,202.26 | $1,445.44 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $602.56 Typical High $707.95 | Professional | 62 · Two surgeons | $501.19 | $602.56 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,047.13 | Professional | None | $794.33 | $891.25 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,778.28 Typical High $3,311.31 | Facility | None | $524.81 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,148.15 | Professional | None | $660.69 | $812.83 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,071.52 | Professional | None | $741.31 | $870.96 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | None | $933.25 | $933.25 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $1,348.96 | Facility | None | $645.65 | $870.96 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Sentara Setting Facility Modifier None Typical Low $645.65 Median $1,905.46 Typical High $10,232.93 | Facility | None | $645.65 | $1,905.46 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $6,025.60 | Professional | None | $630.96 | $891.25 | $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 $524.81 Median $741.31 Typical High $1,258.93 | Professional | None | $524.81 | $741.31 | $1,258.93 |
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 $323.59 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $323.59 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $128.82 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $478.63 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $95.50 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $64.57 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $446.68 | $776.25 | $776.25 |
Where Virginia sits
The same service costs 8.3 times more in Wyoming 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· 36th of 51
$933
WY $4,074UT $490
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.