How much rates vary
Facilitymedian $3,890 · 10th to 90th $776 to $7,079Professionalmedian $933 · 10th to 90th $661 to $1,445
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 $741.31 Median $1,023.29 Typical High $1,174.90 | Professional | None | $741.31 | $1,023.29 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $7,943.28 | Facility | None | $3,311.31 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,122.02 | Professional | None | $616.60 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,981.07 Typical High $4,897.79 | Facility | None | $741.31 | $3,981.07 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,778.28 | Professional | None | $977.24 | $1,122.02 | $1,778.28 |
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 $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | None | $977.24 | $1,023.29 | $1,023.29 |
Health New England Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,584.89 | Professional | None | $660.69 | $1,000.00 | $1,584.89 |
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 $354.81 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $354.81 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $141.25 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $524.81 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $104.71 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $70.79 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $489.78 | $707.95 | $707.95 |
Where Connecticut sits
The same service costs 3.5 times more in Alaska than in Georgia. 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
AK $7,038GA $2,000
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.