How much rates vary
Facilitymedian $1,514 · 10th to 90th $417 to $5,370Professionalmedian $389 · 10th to 90th $263 to $724
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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $758.58 | Professional | None | $281.84 | $295.12 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $549.54 Typical High $549.54 | Professional | None | $245.47 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $741.31 | Professional | None | $251.19 | $389.05 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $616.60 Typical High $1,174.90 | Professional | 50 · Both sides | $426.58 | $616.60 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $263.03 Typical High $489.78 | Professional | 62 · Two surgeons | $181.97 | $263.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,862.09 Typical High $2,344.23 | Facility | None | $398.11 | $1,862.09 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $707.95 | Professional | None | $316.23 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $812.83 | Professional | None | $288.40 | $323.59 | $812.83 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | None | $416.87 | $489.78 | $489.78 |
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 $257.04 Median $446.68 Typical High $724.44 | Professional | None | $257.04 | $446.68 | $724.44 |
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 $141.25 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $56.23 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $208.93 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $194.98 | $199.53 | $218.78 |
Where Georgia sits
The same service costs 7.3 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 $6,269MT $863
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.