How much rates vary
Facilitymedian $1,862 · 10th to 90th $708 to $6,310Professionalmedian $832 · 10th to 90th $562 to $1,514
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 $870.96 Median $5,370.32 Typical High $8,317.64 | Facility | None | $870.96 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,621.81 | Professional | None | $588.84 | $645.65 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $5,754.40 | Facility | None | $676.08 | $1,348.96 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $1,318.26 | Professional | None | $489.78 | $831.76 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $537.03 Typical High $954.99 | Professional | 62 · Two surgeons | $398.11 | $537.03 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,691.53 | Facility | None | $741.31 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,659.59 | Professional | None | $645.65 | $933.25 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,122.02 | Professional | None | $676.08 | $776.25 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $1,905.46 | Professional | None | $537.03 | $954.99 | $1,905.46 |
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 $295.12 Median $295.12 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $295.12 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $436.52 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $114.82 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $537.03 |
Where Georgia sits
The same service costs 4.0 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 $7,771MT $1,932
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.