How much rates vary
Facilitymedian $3,467 · 10th to 90th $813 to $10,000Professionalmedian $4,074 · 10th to 90th $490 to $13,804
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 $467.74 Median $7,079.46 Typical High $14,454.40 | Facility | None | $467.74 | $7,079.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,995.26 Typical High $7,413.10 | Professional | None | $436.52 | $1,995.26 | $7,413.10 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $8,912.51 | Facility | None | $794.33 | $1,513.56 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $4,677.35 Typical High $13,803.84 | Professional | None | $575.44 | $4,677.35 | $13,803.84 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $8,511.38 Typical High $10,964.78 | Facility | None | $616.60 | $8,511.38 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $1,348.96 Typical High $13,489.63 | Professional | None | $524.81 | $1,348.96 | $13,489.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $6,760.83 Typical High $12,882.50 | Professional | None | $478.63 | $6,760.83 | $12,882.50 |
Oscar Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $478.63 Median $5,888.44 Typical High $14,454.40 | Professional | None | $478.63 | $5,888.44 | $14,454.40 |
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 $218.78 Median $2,511.89 Typical High $3,630.78 | Professional | 52 · Reduced service | $218.78 | $2,511.89 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $1,023.29 Typical High $1,445.44 | Professional | 53 · Discontinued | $87.10 | $1,023.29 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $3,801.89 Typical High $5,370.32 | Professional | 54 · Surgery only | $331.13 | $3,801.89 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $758.58 Typical High $1,096.48 | Professional | 55 · Aftercare only | $66.07 | $758.58 | $1,096.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $512.86 Typical High $724.44 | Professional | 56 · Pre-op care only | $43.65 | $512.86 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $3,548.13 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $309.03 | $3,548.13 | $5,011.87 |
Where Georgia sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.