How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $7,943Professionalmedian $692 · 10th to 90th $437 to $1,023
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 $478.63 Median $776.25 Typical High $776.25 | Professional | None | $478.63 | $776.25 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $977.24 | Professional | None | $389.05 | $691.83 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $1,023.29 Typical High $1,445.44 | Professional | 50 · Both sides | $588.84 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,090.30 Typical High $3,801.89 | Facility | None | $741.31 | $3,090.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,096.48 | Professional | None | $588.84 | $691.83 | $1,096.48 |
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 $691.83 Median $691.83 Typical High $870.96 | Professional | None | $691.83 | $691.83 | $870.96 |
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 $407.38 Median $602.56 Typical High $1,230.27 | Professional | None | $407.38 | $602.56 | $1,230.27 |
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 $234.42 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $234.42 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $95.50 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $354.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $70.79 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $47.86 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $331.13 | $549.54 | $549.54 |
Where Connecticut sits
The same service costs 3.6 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 $5,175MT $1,450
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.