How much rates vary
Facilitymedian $4,786 · 10th to 90th $794 to $11,749Professionalmedian $724 · 10th to 90th $427 to $1,122
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 $588.84 Typical High $794.33 | Professional | None | $426.58 | $588.84 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $954.99 | Professional | None | $478.63 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,023.29 Typical High $1,445.44 | Professional | 50 · Both sides | $724.44 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,570.40 Typical High $3,388.44 | Facility | None | $741.31 | $2,570.40 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $1,122.02 | Professional | None | $549.54 | $741.31 | $1,122.02 |
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 $676.08 Median $776.25 Typical High $933.25 | Professional | None | $676.08 | $776.25 | $933.25 |
Health New England Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $346.74 Median $676.08 Typical High $1,412.54 | Professional | None | $346.74 | $676.08 | $1,412.54 |
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 $251.19 Median $288.40 Typical High $398.11 | Professional | 52 · Reduced service | $251.19 | $288.40 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $117.49 Typical High $158.49 | Professional | 53 · Discontinued | $100.00 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $436.52 Typical High $602.56 | Professional | 54 · Surgery only | $371.54 | $436.52 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $87.10 Typical High $120.23 | Professional | 55 · Aftercare only | $75.86 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $57.54 Typical High $79.43 | Professional | 56 · Pre-op care only | $50.12 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $407.38 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $354.81 | $407.38 | $562.34 |
Where Connecticut sits
The same service costs 4.7 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 $6,464MT $1,390
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.