How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,259 to $19,953Professionalmedian $1,259 · 10th to 90th $1,000 to $2,239
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 $1,905.46 Median $7,079.46 Typical High $16,595.87 | Facility | None | $1,905.46 | $7,079.46 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $7,079.46 | Professional | None | $1,023.29 | $1,230.27 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $9,120.11 Typical High $9,772.37 | Facility | None | $7,079.46 | $9,120.11 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,000.00 | $1,202.26 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $7,079.46 | Professional | None | $1,148.15 | $1,288.25 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $12,882.50 Typical High $46,773.51 | Facility | None | $8,511.38 | $12,882.50 | $46,773.51 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,318.26 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,348.96 | Professional | None | $912.01 | $1,096.48 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,548.82 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,995.26 | Facility | None | $1,230.27 | $1,584.89 | $1,995.26 |
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 $912.01 Median $2,454.71 Typical High $10,715.19 | Facility | None | $912.01 | $2,454.71 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $10,232.93 | Professional | None | $1,023.29 | $1,445.44 | $10,232.93 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $9,772.37 Typical High $25,118.86 | Facility | None | $2,570.40 | $9,772.37 | $25,118.86 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $2,290.87 | Professional | None | $954.99 | $1,479.11 | $2,290.87 |
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 $512.86 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $870.96 |
Where Virginia sits
The same service costs 8.9 times more in Oklahoma 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
$1,318
OK $7,762TX $871
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.