How much rates vary
Facilitymedian $5,495 · 10th to 90th $851 to $11,749Professionalmedian $1,380 · 10th to 90th $692 to $1,950
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 $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | None | $758.58 | $1,096.48 | $1,096.48 |
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 $691.83 Median $1,380.38 Typical High $1,819.70 | Professional | None | $691.83 | $1,380.38 | $1,819.70 |
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 $1,202.26 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,258.93 | $1,862.09 |
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 $933.25 Median $1,258.93 Typical High $1,318.26 | Professional | None | $933.25 | $1,258.93 | $1,318.26 |
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 $602.56 Median $1,148.15 Typical High $2,187.76 | Professional | None | $602.56 | $1,148.15 | $2,187.76 |
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 $380.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $380.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $154.88 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $575.44 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $114.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $75.86 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $537.03 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 3.1 times more in Wisconsin than in Hawaii. 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
WI $7,619HI $2,493
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.