How much rates vary
Facilitymedian $4,786 · 10th to 90th $794 to $11,749Professionalmedian $263 · 10th to 90th $174 to $380
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $346.74 | Professional | None | $190.55 | $263.03 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $331.13 | Professional | None | $173.78 | $239.88 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,570.40 Typical High $3,388.44 | Facility | None | $741.31 | $2,570.40 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $537.03 | Professional | None | $245.47 | $316.23 | $537.03 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $309.03 | Professional | None | $295.12 | $309.03 | $309.03 |
United Setting Facility Modifier None Typical Low $776.25 Median $4,786.30 Typical High $8,709.64 | Facility | None | $776.25 | $4,786.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $501.19 | Professional | None | $169.82 | $275.42 | $501.19 |
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 $114.82 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $63.10 | Professional | 53 · Discontinued | $40.74 | $45.71 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $169.82 Typical High $234.42 | Professional | 54 · Surgery only | $151.36 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $46.77 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $158.49 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $141.25 | $158.49 | $218.78 |
Where Connecticut sits
The same service costs 9.3 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 $5,912MT $637
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.