How much rates vary
Facilitymedian $1,023 · 10th to 90th $501 to $7,079Professionalmedian $1,738 · 10th to 90th $1,175 to $2,951
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 $1,318.26 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,318.26 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $3,467.37 | Professional | None | $1,318.26 | $1,445.44 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $8,912.51 | Facility | None | $794.33 | $1,513.56 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $295.12 Typical High $426.58 | Professional | 80 · Assistant surgeon | $199.53 | $295.12 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $257.04 Typical High $371.54 | Professional | AS · PA/NP assist | $173.78 | $257.04 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,905.46 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $7,585.78 | Professional | None | $1,202.26 | $1,445.44 | $7,585.78 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,949.84 | $3,467.37 |
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 $660.69 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,047.13 |
Where Georgia sits
The same service costs 6.3 times more in Colorado than in Maryland. 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 $11,778MD $1,881
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.