How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,047 to $12,589Professionalmedian $955 · 10th to 90th $537 to $1,413
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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,047.13 | Professional | None | $588.84 | $870.96 | $1,047.13 |
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 $562.34 Median $1,023.29 Typical High $1,412.54 | Professional | None | $562.34 | $1,023.29 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $4,466.84 | Facility | None | $1,000.00 | $3,388.44 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,348.96 | Professional | None | $645.65 | $794.33 | $1,348.96 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $3,890.45 | Facility | None | $630.96 | $870.96 | $3,890.45 |
ConnectiCare Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $812.83 | $977.24 |
Health New England Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $891.25 | Professional | None | $436.52 | $436.52 | $891.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $416.87 Median $812.83 Typical High $1,548.82 | Professional | None | $416.87 | $812.83 | $1,548.82 |
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 $295.12 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $117.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $446.68 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $89.13 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $58.88 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $416.87 | $602.56 | $602.56 |
Where Connecticut sits
The same service costs 4.7 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 $8,820MT $1,888
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.