How much rates vary
Facilitymedian $1,318 · 10th to 90th $692 to $5,129Professionalmedian $457 · 10th to 90th $309 to $871
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 $331.13 Median $5,370.32 Typical High $8,317.64 | Facility | None | $331.13 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $870.96 | Professional | None | $331.13 | $398.11 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | None | $288.40 | $288.40 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $851.14 | Professional | None | $309.03 | $457.09 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $676.08 Typical High $1,122.02 | Professional | 50 · Both sides | $446.68 | $676.08 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,584.89 | Facility | None | $741.31 | $1,202.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $891.25 | Professional | None | $363.08 | $501.19 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $1,096.48 | Professional | None | $302.00 | $380.19 | $1,096.48 |
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 $331.13 Median $489.78 Typical High $912.01 | Professional | None | $331.13 | $489.78 | $912.01 |
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 $165.96 Median $165.96 Typical High $213.80 | Professional | 52 · Reduced service | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $85.11 | Professional | 53 · Discontinued | $66.07 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $302.00 |
Where Georgia sits
The same service costs 5.1 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 $5,094MT $991
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.