How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $7,943Professionalmedian $708 · 10th to 90th $417 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 $467.74 Median $831.76 Typical High $831.76 | Professional | None | $467.74 | $831.76 | $831.76 |
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 $398.11 Median $645.65 Typical High $954.99 | Professional | None | $398.11 | $645.65 | $954.99 |
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 $724.44 Typical High $1,023.29 | Professional | None | $588.84 | $724.44 | $1,023.29 |
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 $724.44 Median $724.44 Typical High $794.33 | Professional | None | $724.44 | $724.44 | $794.33 |
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 $616.60 Typical High $1,230.27 | Professional | None | $407.38 | $616.60 | $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 $239.88 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $239.88 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $97.72 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $363.08 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $48.98 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $338.84 | $575.44 | $575.44 |
Where Connecticut sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.