How much rates vary
Facilitymedian $4,169 · 10th to 90th $871 to $9,333Professionalmedian $447 · 10th to 90th $324 to $724
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 $338.84 Median $501.19 Typical High $501.19 | Professional | None | $338.84 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,912.51 | Facility | None | $1,445.44 | $3,715.35 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $676.08 | Professional | None | $281.84 | $446.68 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $660.69 Typical High $1,000.00 | Professional | 50 · Both sides | $416.87 | $660.69 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $4,365.16 | Facility | None | $851.14 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $831.76 | Professional | None | $446.68 | $512.86 | $831.76 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | None | $537.03 | $537.03 | $602.56 |
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 $309.03 Median $416.87 Typical High $851.14 | Professional | None | $309.03 | $416.87 | $851.14 |
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 $169.82 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $169.82 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $67.61 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $251.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $50.12 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.88 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $354.81 |
Where Connecticut sits
The same service costs 5.3 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 $5,518MT $1,050
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.