How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $933 · 10th to 90th $513 to $1,380
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 $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $831.76 | Professional | None | $562.34 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,380.38 | Professional | None | $501.19 | $1,000.00 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,388.44 Typical High $4,265.80 | Facility | None | $851.14 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,380.38 | Professional | None | $870.96 | $1,202.26 | $1,380.38 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,258.93 | Professional | None | $645.65 | $851.14 | $1,258.93 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $436.52 Median $891.25 Typical High $1,513.56 | Professional | None | $436.52 | $891.25 | $1,513.56 |
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 $281.84 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $281.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $112.20 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $426.58 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $85.11 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $56.23 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $398.11 | $575.44 | $575.44 |
Where Connecticut sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.