How much rates vary
Facilitymedian $2,570 · 10th to 90th $631 to $7,244Professionalmedian $1,122 · 10th to 90th $724 to $1,778
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 $891.25 Median $891.25 Typical High $1,000.00 | Professional | None | $891.25 | $891.25 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $7,244.36 | Facility | None | $588.84 | $1,230.27 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,659.59 | Professional | None | $691.83 | $1,122.02 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $707.95 Typical High $1,047.13 | Professional | 62 · Two surgeons | $501.19 | $707.95 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,388.44 Typical High $4,265.80 | Facility | None | $602.56 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,089.30 | Professional | None | $831.76 | $1,202.26 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,288.25 | Professional | None | $741.31 | $891.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $2,290.87 | Professional | None | $776.25 | $1,174.90 | $2,290.87 |
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 $446.68 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $691.83 |
Where Georgia sits
The same service costs 4.2 times more in Alaska 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
AK $10,315MT $2,461
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.