How much rates vary
Facilitymedian $20,417 · 10th to 90th $2,512 to $81,283Professionalmedian $1,479 · 10th to 90th $891 to $2,344
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 $5,248.07 Median $9,772.37 Typical High $61,659.50 | Facility | None | $5,248.07 | $9,772.37 | $61,659.50 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,819.70 | Professional | None | $912.01 | $1,513.56 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $63,095.73 Typical High $89,125.09 | Facility | None | $9,120.11 | $63,095.73 | $89,125.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $2,137.96 | Professional | None | $851.14 | $1,445.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $912.01 Typical High $1,348.96 | Professional | 62 · Two surgeons | $537.03 | $912.01 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $50,118.72 Typical High $50,118.72 | Facility | None | $1,000.00 | $50,118.72 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,445.44 | $2,344.23 |
ConnectiCare Setting Facility Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Facility | None | $12,882.50 | $12,882.50 | $12,882.50 |
ConnectiCare Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
Health New England Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $11,481.54 Typical High $26,302.68 | Facility | None | $2,041.74 | $11,481.54 | $26,302.68 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $3,162.28 | Professional | None | $954.99 | $1,479.11 | $3,162.28 |
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 $501.19 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $501.19 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $199.53 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $100.00 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $691.83 | $1,047.13 | $1,047.13 |
Where Connecticut sits
The same service costs 19.9 times more in Alaska 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
AK $53,750MT $2,699
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.