How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,122 to $14,791Professionalmedian $1,175 · 10th to 90th $955 to $1,820
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 $1,148.15 Median $7,762.47 Typical High $15,488.17 | Facility | None | $1,148.15 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $5,754.40 | Professional | None | $1,071.52 | $1,148.15 | $5,754.40 |
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 $954.99 Median $1,148.15 Typical High $1,479.11 | Professional | None | $954.99 | $1,148.15 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,737.80 Typical High $2,187.76 | Professional | 50 · Both sides | $1,445.44 | $1,737.80 | $2,187.76 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $6,918.31 | Professional | None | $954.99 | $1,071.52 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $5,754.40 | Facility | None | $1,000.00 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,174.90 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,288.25 | Professional | None | $870.96 | $1,047.13 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,659.59 | $1,659.59 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,905.46 | Facility | None | $1,148.15 | $1,380.38 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $10,232.93 | Facility | None | $912.01 | $2,454.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $7,762.47 | Professional | None | $977.24 | $1,348.96 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $2,041.74 | Professional | None | $831.76 | $1,348.96 | $2,041.74 |
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 $537.03 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $537.03 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $213.80 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $794.33 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $741.31 | $812.83 | $812.83 |
Where Virginia sits
The same service costs 7.2 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· 43rd of 51
$1,202
OK $4,677UT $646
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.