How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,072 to $15,488Professionalmedian $1,122 · 10th to 90th $631 to $1,820
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 $6,760.83 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,760.83 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,348.96 | Professional | None | $724.44 | $1,047.13 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $11,748.98 Typical High $16,982.44 | Facility | None | $6,456.54 | $11,748.98 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,258.93 Typical High $1,698.24 | Professional | None | $660.69 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $1,000.00 | $1,819.70 | $2,511.89 |
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 $954.99 Median $1,096.48 Typical High $1,621.81 | Professional | None | $954.99 | $1,096.48 | $1,621.81 |
ConnectiCare Setting Facility Modifier None Typical Low $707.95 Median $5,128.61 Typical High $5,248.07 | Facility | None | $707.95 | $5,128.61 | $5,248.07 |
ConnectiCare Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,230.27 | Professional | None | $758.58 | $1,023.29 | $1,230.27 |
Health New England Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $8,912.51 | Facility | None | $6,456.54 | $6,456.54 | $8,912.51 |
Health New England Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,584.89 | Professional | None | $616.60 | $616.60 | $1,584.89 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $10,000.00 | Facility | None | $870.96 | $5,495.41 | $10,000.00 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,949.84 | Professional | None | $537.03 | $1,000.00 | $1,949.84 |
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 $363.08 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $537.03 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $501.19 | $741.31 | $741.31 |
Where Connecticut sits
The same service costs 3.6 times more in Wisconsin 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
WI $7,904MT $2,218
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.