How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,349 to $23,442Professionalmedian $1,778 · 10th to 90th $562 to $9,550
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 $478.63 Median $870.96 Typical High $7,943.28 | Professional | None | $478.63 | $870.96 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $3,548.13 Typical High $9,549.93 | Professional | None | $562.34 | $3,548.13 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $14,125.38 Typical High $17,378.01 | Facility | None | $851.14 | $14,125.38 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $10,000.00 | Professional | None | $616.60 | $1,202.26 | $10,000.00 |
ConnectiCare Setting Professional Modifier None Typical Low $4,570.88 Median $7,413.10 Typical High $8,912.51 | Professional | None | $4,570.88 | $7,413.10 | $8,912.51 |
Health New England Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Health New England Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $9,549.93 Typical High $18,197.01 | Facility | None | $1,348.96 | $9,549.93 | $18,197.01 |
United Setting Professional Modifier None Typical Low $501.19 Median $2,454.71 Typical High $14,125.38 | Professional | None | $501.19 | $2,454.71 | $14,125.38 |
5 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 $331.13 Median $380.19 Typical High $3,890.45 | Professional | 52 · Reduced service | $331.13 | $380.19 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $154.88 Typical High $1,548.82 | Professional | 53 · Discontinued | $131.83 | $154.88 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $575.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $501.19 | $575.44 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $114.82 Typical High $1,174.90 | Professional | 55 · Aftercare only | $100.00 | $114.82 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $75.86 Typical High $776.25 | Professional | 56 · Pre-op care only | $66.07 | $75.86 | $776.25 |
Where Connecticut sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.