How much rates vary
Facilitymedian $912 · 10th to 90th $513 to $4,571Professionalmedian $457 · 10th to 90th $316 to $794
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 $588.84 Median $5,011.87 Typical High $7,943.28 | Facility | None | $588.84 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $588.84 | Professional | None | $331.13 | $331.13 | $588.84 |
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 $309.03 Median $457.09 Typical High $741.31 | Professional | None | $309.03 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $691.83 Typical High $1,174.90 | Professional | 50 · Both sides | $489.78 | $691.83 | $1,174.90 |
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 $363.08 Median $501.19 Typical High $870.96 | Professional | None | $363.08 | $501.19 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $741.31 | Professional | None | $354.81 | $389.05 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $870.96 | Professional | None | $281.84 | $457.09 | $870.96 |
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 $165.96 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $245.47 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $257.04 |
Where Georgia sits
The same service costs 4.6 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 $4,822MT $1,050
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.