How much rates vary
Facilitymedian $3,802 · 10th to 90th $871 to $13,490Professionalmedian $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 $4,073.80 Typical High $10,000.00 | Facility | None | $954.99 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $2,570.40 | Professional | None | $870.96 | $954.99 | $2,570.40 |
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 $794.33 Median $954.99 Typical High $1,202.26 | Professional | None | $794.33 | $954.99 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $1,819.70 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $4,365.16 | Professional | None | $794.33 | $870.96 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,479.11 Typical High $2,818.38 | Facility | None | $346.74 | $1,479.11 | $2,818.38 |
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 $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,348.96 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,548.82 | Facility | None | $954.99 | $1,122.02 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Sentara Setting Facility Modifier None Typical Low $707.95 Median $2,187.76 Typical High $10,232.93 | Facility | None | $707.95 | $2,187.76 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $7,413.10 | Professional | None | $794.33 | $1,096.48 | $7,413.10 |
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 $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 $436.52 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $660.69 |
Where Virginia sits
The same service costs 6.9 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· 38th of 51
$1,000
OK $3,890UT $562
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.