How much rates vary
Facilitymedian $1,259 · 10th to 90th $513 to $5,012Professionalmedian $380 · 10th to 90th $219 to $759
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 $251.19 Median $3,548.13 Typical High $7,585.78 | Facility | None | $251.19 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $831.76 | Professional | None | $229.09 | $436.52 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $812.83 | Professional | None | $208.93 | $338.84 | $812.83 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $630.96 Typical High $1,348.96 | Professional | 50 · Both sides | $275.42 | $630.96 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $1,071.52 Typical High $4,677.35 | Facility | None | $501.19 | $1,071.52 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $446.68 | Professional | None | $199.53 | $331.13 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $501.19 Typical High $691.83 | Professional | 50 · Both sides | $371.54 | $501.19 | $691.83 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $602.56 | Professional | None | $380.19 | $489.78 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,096.48 Typical High $1,445.44 | Facility | None | $512.86 | $1,096.48 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $467.74 Typical High $1,174.90 | Professional | None | $257.04 | $467.74 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $512.86 Typical High $3,467.37 | Professional | None | $218.78 | $512.86 | $3,467.37 |
Oscar Health Setting Facility Modifier None Typical Low $1,023.29 Median $5,888.44 Typical High $8,709.64 | Facility | None | $1,023.29 | $5,888.44 | $8,709.64 |
Oscar Health Setting Professional Modifier None Typical Low $275.42 Median $616.60 Typical High $776.25 | Professional | None | $275.42 | $616.60 | $776.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,128.61 | Facility | None | $851.14 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $977.24 | Professional | None | $234.42 | $436.52 | $977.24 |
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 $114.82 Median $181.97 Typical High $234.42 | Professional | 52 · Reduced service | $114.82 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $72.44 Typical High $93.33 | Professional | 53 · Discontinued | $45.71 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $269.15 Typical High $346.74 | Professional | 54 · Surgery only | $173.78 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $54.95 Typical High $69.18 | Professional | 55 · Aftercare only | $34.67 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $46.77 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $251.19 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $162.18 | $251.19 | $323.59 |
Where Georgia sits
The same service costs 4.6 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 $4,728MT $1,029
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.