How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $7,943Professionalmedian $708 · 10th to 90th $380 to $1,047
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 $426.58 Median $616.60 Typical High $616.60 | Professional | None | $426.58 | $616.60 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $741.31 Typical High $1,023.29 | Professional | None | $371.54 | $741.31 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $1,096.48 Typical High $1,548.82 | Professional | 50 · Both sides | $549.54 | $1,096.48 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,862.09 Typical High $2,398.83 | Facility | None | $741.31 | $1,862.09 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,023.29 | Professional | None | $645.65 | $812.83 | $1,023.29 |
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 $489.78 Median $645.65 Typical High $851.14 | Professional | None | $489.78 | $645.65 | $851.14 |
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 $323.59 Median $645.65 Typical High $1,122.02 | Professional | None | $323.59 | $645.65 | $1,122.02 |
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 $213.80 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $213.80 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $85.11 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $323.59 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $64.57 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $42.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $302.00 | $436.52 | $436.52 |
Where Connecticut sits
The same service costs 3.7 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 $5,056MT $1,384
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.