How much rates vary
Facilitymedian $1,778 · 10th to 90th $562 to $5,888Professionalmedian $933 · 10th to 90th $661 to $1,698
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 $676.08 Median $4,897.79 Typical High $7,943.28 | Facility | None | $676.08 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,778.28 | Professional | None | $676.08 | $724.44 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $1,023.29 Typical High $1,148.15 | Professional | None | $281.84 | $1,023.29 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,621.81 | Professional | None | $645.65 | $933.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,513.56 Typical High $2,511.89 | Professional | 50 · Both sides | $1,023.29 | $1,513.56 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $630.96 Typical High $1,071.52 | Professional | 62 · Two surgeons | $426.58 | $630.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,905.46 Typical High $2,344.23 | Facility | None | $524.81 | $1,905.46 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,737.80 | Professional | None | $758.58 | $1,122.02 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,659.59 | Professional | None | $691.83 | $776.25 | $1,659.59 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,148.15 | $1,174.90 |
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 $630.96 Median $1,047.13 Typical High $1,778.28 | Professional | None | $630.96 | $1,047.13 | $1,778.28 |
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 $338.84 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $524.81 |
Where Georgia sits
The same service costs 3.5 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 $7,283HI $2,091
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.