How much rates vary
Facilitymedian $1,479 · 10th to 90th $550 to $5,012Professionalmedian $457 · 10th to 90th $240 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 $338.84 Median $5,011.87 Typical High $7,943.28 | Facility | None | $338.84 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $912.01 | Professional | None | $331.13 | $363.08 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $229.09 Median $457.09 Typical High $676.08 | Professional | None | $229.09 | $457.09 | $676.08 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,511.89 | Facility | None | $602.56 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $933.25 | Professional | None | $263.03 | $363.08 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $537.03 | Professional | None | $309.03 | $407.38 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $660.69 | Professional | None | $489.78 | $549.54 | $660.69 |
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 $234.42 Median $371.54 Typical High $1,023.29 | Professional | None | $234.42 | $371.54 | $1,023.29 |
8 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 $151.36 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $60.26 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $223.87 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $239.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $208.93 | $239.88 | $275.42 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 51 · Multiple procedures | $229.09 | $229.09 | $229.09 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Where Georgia sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.