How much rates vary
Facilitymedian $4,786 · 10th to 90th $759 to $11,749Professionalmedian $282 · 10th to 90th $204 to $468
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 $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $323.59 | Professional | None | $218.78 | $323.59 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,128.31 Typical High $13,489.63 | Facility | None | $4,786.30 | $8,128.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $436.52 | Professional | None | $194.98 | $281.84 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $426.58 Typical High $645.65 | Professional | 50 · Both sides | $288.40 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,548.13 Typical High $4,365.16 | Facility | None | $549.54 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $537.03 | Professional | None | $288.40 | $331.13 | $537.03 |
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 $346.74 Median $346.74 Typical High $380.19 | Professional | None | $346.74 | $346.74 | $380.19 |
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 $199.53 Median $275.42 Typical High $549.54 | Professional | None | $199.53 | $275.42 | $549.54 |
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 $107.15 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $107.15 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $42.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $162.18 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $32.36 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $21.38 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $151.36 | $229.09 | $229.09 |
Where Connecticut sits
The same service costs 9.6 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 $6,197MT $647
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.