How much rates vary
Facilitymedian $1,585 · 10th to 90th $437 to $6,310Professionalmedian $1,072 · 10th to 90th $692 to $1,862
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 $933.25 Median $3,548.13 Typical High $7,585.78 | Facility | None | $933.25 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $2,398.83 | Professional | None | $912.01 | $1,023.29 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,412.54 | Professional | None | $758.58 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,148.15 Typical High $7,244.36 | Facility | None | $389.05 | $1,148.15 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,621.81 | Professional | None | $676.08 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,621.81 Typical High $2,454.71 | Professional | 50 · Both sides | $1,148.15 | $1,621.81 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $2,454.71 Typical High $3,090.30 | Facility | None | $398.11 | $2,454.71 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,137.96 | Professional | None | $758.58 | $1,174.90 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,621.81 | Professional | None | $851.14 | $954.99 | $1,621.81 |
Oscar Health Setting Facility Modifier None Typical Low $4,786.30 Median $6,309.57 Typical High $6,309.57 | Facility | None | $4,786.30 | $6,309.57 | $6,309.57 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,230.27 | $1,230.27 |
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 $724.44 Median $1,096.48 Typical High $2,187.76 | Professional | None | $724.44 | $1,096.48 | $2,187.76 |
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 $457.09 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $691.83 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $724.44 |
Where Georgia sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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
AK $8,807SC $1,633
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.