How much rates vary
Facilitymedian $891 · 10th to 90th $427 to $4,266Professionalmedian $575 · 10th to 90th $363 to $1,000
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 $426.58 Median $3,630.78 Typical High $7,585.78 | Facility | None | $426.58 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $512.86 | Professional | None | $407.38 | $446.68 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $912.01 | Professional | None | $338.84 | $575.44 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $870.96 Typical High $1,412.54 | Professional | 50 · Both sides | $616.60 | $870.96 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $1,348.96 | Facility | None | $524.81 | $1,000.00 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,148.15 | Professional | None | $457.09 | $660.69 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $891.25 | Professional | None | $489.78 | $616.60 | $891.25 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $1,148.15 | Professional | None | $371.54 | $588.84 | $1,148.15 |
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 $204.17 Median $218.78 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $331.13 |
Where Georgia sits
The same service costs 4.5 times more in Vermont than in Florida. 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
VT $4,521FL $1,007
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.