How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $7,943Professionalmedian $263 · 10th to 90th $174 to $407
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 $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | None | $165.96 | $263.03 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,548.13 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $380.19 | Professional | None | $158.49 | $275.42 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,548.13 Typical High $4,466.84 | Facility | None | $741.31 | $3,548.13 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $398.11 | Professional | None | $251.19 | $302.00 | $398.11 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $602.56 Typical High $758.58 | Facility | None | $446.68 | $602.56 | $758.58 |
ConnectiCare Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $331.13 | Professional | None | $323.59 | $331.13 | $331.13 |
Health New England Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $190.55 Median $269.15 Typical High $549.54 | Professional | None | $190.55 | $269.15 | $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 $91.20 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $91.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $36.31 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $26.92 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.20 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $186.21 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $125.89 | $186.21 | $186.21 |
Where Connecticut sits
The same service costs 8.1 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 $4,634MT $570
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.