How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,259 to $37,154Professionalmedian $1,318 · 10th to 90th $912 to $2,344
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 $1,047.13 Median $7,079.46 Typical High $14,454.40 | Facility | None | $1,047.13 | $7,079.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,071.52 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $34,673.69 | Facility | None | $1,288.25 | $2,290.87 | $34,673.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $2,041.74 | Professional | None | $912.01 | $1,348.96 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $954.99 Typical High $1,348.96 | Professional | 62 · Two surgeons | $616.60 | $954.99 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $28,183.83 Typical High $38,018.94 | Facility | None | $602.56 | $28,183.83 | $38,018.94 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,905.46 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $2,951.21 | Professional | None | $954.99 | $1,047.13 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $18,197.01 Typical High $53,703.18 | Facility | None | $1,513.56 | $18,197.01 | $53,703.18 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $3,019.95 | Professional | None | $954.99 | $1,479.11 | $3,019.95 |
7 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 $501.19 Median $524.81 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $251.19 | Professional | 53 · Discontinued | $199.53 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $870.96 |
Ambetter Setting Professional Modifier Q0 · Research study, investigational Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | Q0 · Research study, investigational | $1,513.56 | $1,513.56 | $1,584.89 |
Where Georgia sits
The same service costs 19.9 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 $53,750MT $2,699
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.