How much rates vary
Facilitymedian $1,318 · 10th to 90th $417 to $4,677Professionalmedian $355 · 10th to 90th $245 to $575
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 $467.74 Median $3,548.13 Typical High $7,585.78 | Facility | None | $467.74 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $1,380.38 | Professional | None | $288.40 | $323.59 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $537.03 | Professional | None | $245.47 | $354.81 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $389.05 Median $524.81 Typical High $812.83 | Professional | 50 · Both sides | $389.05 | $524.81 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $229.09 Typical High $354.81 | Professional | 62 · Two surgeons | $162.18 | $229.09 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,258.93 Typical High $1,659.59 | Facility | None | $398.11 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $676.08 | Professional | None | $281.84 | $416.87 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $602.56 | Professional | None | $239.88 | $275.42 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $239.88 Median $363.08 Typical High $691.83 | Professional | None | $239.88 | $363.08 | $691.83 |
5 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 $144.54 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $33.88 |
Where Georgia sits
The same service costs 6.4 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 $4,783MT $743
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.