How much rates vary
Facilitymedian $1,413 · 10th to 90th $525 to $5,370Professionalmedian $513 · 10th to 90th $316 to $1,023
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 $309.03 Median $3,630.78 Typical High $7,585.78 | Facility | None | $309.03 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $1,318.26 | Professional | None | $281.84 | $501.19 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $316.23 Median $478.63 Typical High $912.01 | Professional | None | $316.23 | $478.63 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $724.44 Typical High $1,380.38 | Professional | 50 · Both sides | $501.19 | $724.44 | $1,380.38 |
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 $371.54 Median $758.58 Typical High $1,288.25 | Professional | None | $371.54 | $758.58 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $691.83 | Professional | None | $363.08 | $645.65 | $691.83 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $1,096.48 | Professional | None | $426.58 | $660.69 | $1,096.48 |
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 $338.84 Median $602.56 Typical High $1,348.96 | Professional | None | $338.84 | $602.56 | $1,348.96 |
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 $141.25 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $141.25 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $56.23 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $323.59 Typical High $389.05 | Professional | 54 · Surgery only | $213.80 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $42.66 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $199.53 | $302.00 | $363.08 |
Where Georgia sits
The same service costs 5.3 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 $6,438MT $1,226
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.