How much rates vary
Facilitymedian $851 · 10th to 90th $468 to $5,012Professionalmedian $219 · 10th to 90th $155 to $380
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 $165.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $165.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $912.01 | Professional | None | $162.18 | $165.96 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $5,011.87 | Facility | None | $524.81 | $1,096.48 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $346.74 | Professional | None | $154.88 | $223.87 | $346.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $100.00 Median $162.18 Typical High $223.87 | Professional | 62 · Two surgeons | $100.00 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $524.81 | Professional | None | $173.78 | $331.13 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $1,174.90 | Professional | None | $151.36 | $173.78 | $1,174.90 |
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 $154.88 Median $251.19 Typical High $501.19 | Professional | None | $154.88 | $251.19 | $501.19 |
5 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 $81.28 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $81.28 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $32.36 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $123.03 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $19.95 |
Where Georgia sits
The same service costs 13.9 times more in Maine 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
ME $6,102MT $438
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.