How much rates vary
Facilitymedian $3,467 · 10th to 90th $832 to $6,607Professionalmedian $324 · 10th to 90th $166 to $447
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 $2,754.23 Median $4,365.16 Typical High $7,585.78 | Facility | None | $2,754.23 | $4,365.16 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | None | $173.78 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $3,715.35 Typical High $6,025.60 | Facility | None | $2,754.23 | $3,715.35 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $331.13 Typical High $426.58 | Professional | None | $165.96 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,380.38 Typical High $1,659.59 | Facility | None | $549.54 | $1,380.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $467.74 | Professional | None | $234.42 | $323.59 | $467.74 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $562.34 | Facility | None | $331.13 | $446.68 | $562.34 |
ConnectiCare Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $398.11 | Professional | None | $186.21 | $316.23 | $398.11 |
United Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $7,413.10 | Facility | None | $660.69 | $2,691.53 | $7,413.10 |
United Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $588.84 | Professional | None | $151.36 | $269.15 | $588.84 |
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 $87.10 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $87.10 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $26.30 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.38 | $25.70 | $25.70 |
Where Connecticut sits
The same service costs 7.7 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 $4,047MT $526
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.