How much rates vary
Facilitymedian $832 · 10th to 90th $120 to $12,023Professionalmedian $1,148 · 10th to 90th $741 to $1,995
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 $831.76 Median $3,715.35 Typical High $15,135.61 | Facility | None | $831.76 | $3,715.35 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $2,187.76 | Professional | None | $831.76 | $891.25 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $19,952.62 | Facility | None | $512.86 | $1,000.00 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $1,862.09 | Professional | None | $741.31 | $1,148.15 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $229.09 Typical High $323.59 | Professional | 80 · Assistant surgeon | $131.83 | $229.09 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $169.82 Typical High $275.42 | Professional | AS · PA/NP assist | $117.49 | $169.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $7,413.10 | Facility | None | $512.86 | $912.01 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,137.96 | Professional | None | $954.99 | $1,348.96 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,995.26 | Professional | None | $831.76 | $954.99 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,445.44 | $1,445.44 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,995.26 | Facility | None | $79.43 | $158.49 | $1,995.26 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,230.27 Typical High $2,137.96 | Professional | None | $741.31 | $1,230.27 | $2,137.96 |
5 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 $416.87 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $416.87 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $95.50 |
Where Georgia sits
The same service costs 8.2 times more in Alabama than in Delaware. 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
AL $7,738DE $946
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.