How much rates vary
Facilitymedian $1,479 · 10th to 90th $550 to $5,012Professionalmedian $741 · 10th to 90th $437 to $1,288
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 $562.34 Median $4,466.84 Typical High $7,585.78 | Facility | None | $562.34 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $758.58 | Professional | None | $398.11 | $562.34 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,288.25 | Professional | None | $457.09 | $741.31 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $2,187.76 | Facility | None | $524.81 | $1,698.24 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $776.25 Typical High $1,318.26 | Professional | None | $436.52 | $776.25 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $977.24 | Professional | None | $436.52 | $660.69 | $977.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,479.11 | Professional | None | $416.87 | $776.25 | $1,479.11 |
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 $199.53 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $199.53 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $79.43 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $302.00 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $60.26 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $39.81 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $281.84 | $389.05 | $446.68 |
Where Georgia sits
The same service costs 4.6 times more in Oklahoma 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
OK $6,614MT $1,440
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.