How much rates vary
Facilitymedian $1,950 · 10th to 90th $631 to $8,128Professionalmedian $977 · 10th to 90th $631 to $1,660
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 $741.31 Median $5,623.41 Typical High $13,803.84 | Facility | None | $741.31 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,862.09 | Professional | None | $707.95 | $758.58 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,412.54 | Professional | None | $602.56 | $707.95 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,230.27 Typical High $7,585.78 | Facility | None | $575.44 | $1,230.27 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,584.89 | Professional | None | $630.96 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,513.56 Typical High $2,454.71 | Professional | 50 · Both sides | $1,047.13 | $1,513.56 | $2,454.71 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,023.29 | Professional | None | $645.65 | $831.76 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $2,691.53 | Facility | None | $602.56 | $1,949.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,819.70 | Professional | None | $794.33 | $1,122.02 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,905.46 | Professional | None | $724.44 | $812.83 | $1,905.46 |
Oscar Health Setting Facility Modifier None Typical Low $4,786.30 Median $17,782.79 Typical High $20,417.38 | Facility | None | $4,786.30 | $17,782.79 | $20,417.38 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,445.44 | Professional | None | $707.95 | $1,202.26 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,995.26 | $7,943.28 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,862.09 | Professional | None | $630.96 | $1,023.29 | $1,862.09 |
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 $354.81 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $562.34 |
Where Georgia sits
The same service costs 3.6 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 $7,904MT $2,218
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.