How much rates vary
Facilitymedian $1,413 · 10th to 90th $525 to $5,370Professionalmedian $263 · 10th to 90th $178 to $501
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 $165.96 Median $3,630.78 Typical High $7,413.10 | Facility | None | $165.96 | $3,630.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $602.56 | Professional | None | $151.36 | $251.19 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $245.47 | Professional | None | $162.18 | $162.18 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $457.09 | Professional | None | $177.83 | $251.19 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,445.44 Typical High $1,905.46 | Facility | None | $524.81 | $1,445.44 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $407.38 Typical High $645.65 | Professional | None | $204.17 | $407.38 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $354.81 | Professional | None | $199.53 | $309.03 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $380.19 | Professional | None | $229.09 | $331.13 | $380.19 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $676.08 | Professional | None | $186.21 | $323.59 | $676.08 |
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 $75.86 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $75.86 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $30.20 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $114.82 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.14 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $177.83 |
Where Georgia sits
The same service costs 9.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $5,912MT $637
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.