How much rates vary
Facilitymedian $912 · 10th to 90th $501 to $4,571Professionalmedian $347 · 10th to 90th $204 to $776
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 $194.98 Median $4,897.79 Typical High $7,943.28 | Facility | None | $194.98 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $575.44 | Professional | None | $194.98 | $208.93 | $575.44 |
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 $245.47 Median $354.81 Typical High $812.83 | Professional | None | $245.47 | $354.81 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $245.47 Typical High $512.86 | Professional | 62 · Two surgeons | $162.18 | $245.47 | $512.86 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $1,380.38 | Facility | None | $524.81 | $1,023.29 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $446.68 Typical High $616.60 | Professional | None | $234.42 | $446.68 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $1,122.02 | Professional | None | $208.93 | $251.19 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | None | $309.03 | $309.03 | $338.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $630.96 | Professional | None | $208.93 | $363.08 | $630.96 |
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 $97.72 Median $97.72 Typical High $141.25 | Professional | 52 · Reduced service | $97.72 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $38.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $147.91 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $41.69 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.50 | $19.95 | $28.18 |
Where Georgia sits
The same service costs 6.8 times more in Colorado 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
CO $4,179MT $618
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.