How much rates vary
Facilitymedian $1,820 · 10th to 90th $617 to $6,166Professionalmedian $741 · 10th to 90th $501 to $1,349
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 $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $501.19 Median $758.58 Typical High $1,348.96 | Professional | None | $501.19 | $758.58 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,202.26 Typical High $2,137.96 | Professional | 50 · Both sides | $831.76 | $1,202.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $501.19 Typical High $891.25 | Professional | 62 · Two surgeons | $346.74 | $501.19 | $891.25 |
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 $630.96 Median $891.25 Typical High $1,412.54 | Professional | None | $630.96 | $891.25 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,318.26 | Professional | None | $562.34 | $630.96 | $1,318.26 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $954.99 | Professional | None | $831.76 | $954.99 | $954.99 |
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 $512.86 Median $831.76 Typical High $1,445.44 | Professional | None | $512.86 | $831.76 | $1,445.44 |
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 $275.42 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $436.52 |
Where Georgia sits
The same service costs 4.3 times more in Wisconsin 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
WI $7,406MT $1,722
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.