How much rates vary
Facilitymedian $1,318 · 10th to 90th $603 to $5,129Professionalmedian $759 · 10th to 90th $479 to $1,318
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 $630.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $630.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,659.59 | Professional | None | $630.96 | $707.95 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,071.52 | Professional | None | $457.09 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,122.02 Typical High $1,584.89 | Professional | 50 · Both sides | $812.83 | $1,122.02 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $1,737.80 | Facility | None | $602.56 | $1,258.93 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,479.11 | Professional | None | $602.56 | $891.25 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,584.89 | Professional | None | $562.34 | $630.96 | $1,584.89 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $851.14 | Professional | None | $707.95 | $812.83 | $851.14 |
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 $512.86 Median $758.58 Typical High $1,513.56 | Professional | None | $512.86 | $758.58 | $1,513.56 |
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 $316.23 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $316.23 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $125.89 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $501.19 |
Where Georgia sits
The same service costs 3.7 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 $6,126MT $1,645
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.