How much rates vary
Facilitymedian $4,786 · 10th to 90th $813 to $12,303Professionalmedian $479 · 10th to 90th $295 to $776
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 $295.12 Median $407.38 Typical High $630.96 | Professional | None | $295.12 | $407.38 | $630.96 |
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 $354.81 Median $489.78 Typical High $645.65 | Professional | None | $354.81 | $489.78 | $645.65 |
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 $380.19 Median $478.63 Typical High $851.14 | Professional | None | $380.19 | $478.63 | $851.14 |
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 $478.63 Median $588.84 Typical High $707.95 | Professional | None | $478.63 | $588.84 | $707.95 |
Health New England Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $234.42 Median $478.63 Typical High $1,071.52 | Professional | None | $234.42 | $478.63 | $1,071.52 |
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 $186.21 Median $194.98 Typical High $309.03 | Professional | 52 · Reduced service | $186.21 | $194.98 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $125.89 | Professional | 53 · Discontinued | $75.86 | $79.43 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $467.74 | Professional | 54 · Surgery only | $281.84 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $58.88 Typical High $93.33 | Professional | 55 · Aftercare only | $56.23 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.90 Typical High $63.10 | Professional | 56 · Pre-op care only | $38.02 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $275.42 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $263.03 | $275.42 | $436.52 |
Where Connecticut sits
The same service costs 6.3 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 $6,296MT $1,002
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.