How much rates vary
Facilitymedian $1,318 · 10th to 90th $550 to $5,012Professionalmedian $490 · 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 $426.58 Median $5,011.87 Typical High $7,943.28 | Facility | None | $426.58 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $1,071.52 | Professional | None | $407.38 | $457.09 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $616.60 | Professional | None | $309.03 | $323.59 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $707.95 | Professional | None | $302.00 | $489.78 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $1,659.59 | Facility | None | $524.81 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $954.99 | Professional | None | $389.05 | $575.44 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $575.44 | Professional | None | $371.54 | $426.58 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $602.56 | Professional | None | $426.58 | $467.74 | $602.56 |
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 $338.84 Median $512.86 Typical High $1,000.00 | Professional | None | $338.84 | $512.86 | $1,000.00 |
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 $199.53 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $288.40 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $281.84 | $288.40 | $323.59 |
Where Georgia sits
The same service costs 4.5 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 $4,914MT $1,099
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.