How much rates vary
Facilitymedian $1,318 · 10th to 90th $525 to $5,012Professionalmedian $282 · 10th to 90th $182 to $589
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 $389.05 Median $4,466.84 Typical High $7,585.78 | Facility | None | $389.05 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $870.96 | Professional | None | $204.17 | $389.05 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $177.83 Median $251.19 Typical High $446.68 | Professional | None | $177.83 | $251.19 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $371.54 Typical High $724.44 | Professional | 50 · Both sides | $269.15 | $371.54 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $1,659.59 | Facility | None | $537.03 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $380.19 Typical High $758.58 | Professional | None | $190.55 | $380.19 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $398.11 Typical High $549.54 | Professional | None | $194.98 | $398.11 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $190.55 Median $371.54 Typical High $707.95 | Professional | None | $190.55 | $371.54 | $707.95 |
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 $102.33 Median $158.49 Typical High $208.93 | Professional | 52 · Reduced service | $102.33 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $40.74 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $234.42 Typical High $316.23 | Professional | 54 · Surgery only | $154.88 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $218.78 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $144.54 | $218.78 | $295.12 |
Where Georgia sits
The same service costs 6.3 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 $4,654MT $736
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.