How much rates vary
Facilitymedian $5,495 · 10th to 90th $871 to $11,749Professionalmedian $1,000 · 10th to 90th $589 to $1,549
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 $4,570.88 Median $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $870.96 | Professional | None | $575.44 | $870.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $11,748.98 Typical High $13,803.84 | Facility | None | $933.25 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,174.90 Typical High $1,584.89 | Professional | None | $630.96 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $741.31 Typical High $1,000.00 | Professional | 62 · Two surgeons | $398.11 | $741.31 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $4,786.30 | Facility | None | $1,000.00 | $3,630.78 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,318.26 | Professional | None | $724.44 | $812.83 | $1,318.26 |
ConnectiCare Setting Facility Modifier None Typical Low $630.96 Median $851.14 Typical High $1,023.29 | Facility | None | $630.96 | $851.14 | $1,023.29 |
ConnectiCare Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,000.00 | Professional | None | $724.44 | $912.01 | $1,000.00 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $524.81 Median $912.01 Typical High $2,041.74 | Professional | None | $524.81 | $912.01 | $2,041.74 |
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 $288.40 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $288.40 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $436.52 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $87.10 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $407.38 | $616.60 | $616.60 |
Where Connecticut sits
The same service costs 4.0 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 $7,771MT $1,932
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.