How much rates vary
Facilitymedian $3,631 · 10th to 90th $832 to $7,586Professionalmedian $1,288 · 10th to 90th $708 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 $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 $794.33 Median $1,148.15 Typical High $1,202.26 | Professional | None | $794.33 | $1,148.15 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $8,912.51 | Facility | None | $3,548.13 | $4,168.69 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,380.38 Typical High $1,949.84 | Professional | None | $707.95 | $1,380.38 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $2,041.74 Typical High $2,951.21 | Professional | 50 · Both sides | $1,047.13 | $2,041.74 | $2,951.21 |
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 $1,122.02 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,258.93 | $1,778.28 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $758.58 | Facility | None | $331.13 | $457.09 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,348.96 | Professional | None | $954.99 | $1,174.90 | $1,348.96 |
Health New England Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
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 $588.84 Median $1,096.48 Typical High $2,041.74 | Professional | None | $588.84 | $1,096.48 | $2,041.74 |
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 $389.05 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $389.05 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $588.84 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $117.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $549.54 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 3.6 times more in Alaska than in Alabama. 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 $5,545AL $1,558
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.