How much rates vary
Facilitymedian $1,820 · 10th to 90th $631 to $6,166Professionalmedian $1,122 · 10th to 90th $759 to $1,862
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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,122.02 | Professional | None | $812.83 | $831.76 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,778.28 | Professional | None | $741.31 | $1,122.02 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,511.89 | Facility | None | $602.56 | $1,905.46 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,089.30 | Professional | None | $851.14 | $1,148.15 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,445.44 | Professional | None | $891.25 | $977.24 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,778.28 | Professional | None | $831.76 | $1,380.38 | $1,778.28 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,089.30 | Professional | None | $691.83 | $1,174.90 | $2,089.30 |
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 $398.11 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $630.96 |
Where Georgia sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.