How much rates vary
Facilitymedian $550 · 10th to 90th $257 to $3,548Professionalmedian $363 · 10th to 90th $245 to $646
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 $338.84 Median $3,548.13 Typical High $7,585.78 | Facility | None | $338.84 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $707.95 | Professional | None | $263.03 | $371.54 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $575.44 | Professional | None | $288.40 | $389.05 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $562.34 | Professional | None | $229.09 | $346.74 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $537.03 Typical High $851.14 | Professional | 50 · Both sides | $363.08 | $537.03 | $851.14 |
CareSource Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $257.04 Typical High $645.65 | Facility | None | $194.98 | $257.04 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $489.78 Typical High $794.33 | Professional | None | $245.47 | $489.78 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $851.14 | Professional | None | $251.19 | $363.08 | $851.14 |
Oscar Health Setting Facility Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Facility | None | $676.08 | $1,000.00 | $1,000.00 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $446.68 | Professional | None | $295.12 | $371.54 | $446.68 |
United Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $2,454.71 | Facility | None | $331.13 | $489.78 | $2,454.71 |
United Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $724.44 | Professional | None | $263.03 | $457.09 | $724.44 |
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 $131.83 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $131.83 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $60.26 Typical High $75.86 | Professional | 53 · Discontinued | $52.48 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $223.87 Typical High $281.84 | Professional | 54 · Surgery only | $199.53 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $26.30 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $263.03 |
Where Georgia sits
The same service costs 4.2 times more in Alaska than in Utah. 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.
Georgia· 31st of 51
$372
AK $955UT $229
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.