How much rates vary
Facilitymedian $1,349 · 10th to 90th $589 to $5,012Professionalmedian $912 · 10th to 90th $631 to $1,660
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 $724.44 Median $5,370.32 Typical High $7,762.47 | Facility | None | $724.44 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,122.02 | Professional | None | $575.44 | $724.44 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,584.89 | Professional | None | $645.65 | $891.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $1,819.70 | Facility | None | $602.56 | $1,318.26 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $1,288.25 Typical High $1,737.80 | Professional | None | $562.34 | $1,288.25 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,148.15 | Professional | None | $676.08 | $977.24 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,258.93 | Professional | None | $851.14 | $1,071.52 | $1,258.93 |
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 $691.83 Median $1,096.48 Typical High $2,137.96 | Professional | None | $691.83 | $1,096.48 | $2,137.96 |
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 $288.40 Median $363.08 Typical High $436.52 | Professional | 52 · Reduced service | $288.40 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $144.54 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $537.03 Typical High $645.65 | Professional | 54 · Surgery only | $426.58 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $109.65 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $72.44 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $501.19 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $398.11 | $501.19 | $602.56 |
Where Georgia sits
The same service costs 3.1 times more in Alaska than in Maryland. 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
AK $5,990MD $1,938
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.