How much rates vary
Facilitymedian $129 · 10th to 90th $63 to $269Professionalmedian $145 · 10th to 90th $89 to $339
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 $63.10 Median $128.82 Typical High $128.82 | Facility | None | $63.10 | $128.82 | $128.82 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $46.77 Median $46.77 Typical High $95.50 | Facility | 54 · Surgery only | $46.77 | $46.77 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $181.97 | Professional | None | $60.26 | $112.20 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $61.66 Typical High $102.33 | Professional | 54 · Surgery only | $45.71 | $61.66 | $102.33 |
BCBS Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $346.74 | Professional | None | $104.71 | $158.49 | $346.74 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $125.89 Median $190.55 Typical High $416.87 | Professional | 22 · Increased work | $125.89 | $190.55 | $416.87 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $239.88 Typical High $512.86 | Professional | 50 · Both sides | $158.49 | $239.88 | $512.86 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $112.20 Typical High $239.88 | Professional | 54 · Surgery only | $74.13 | $112.20 | $239.88 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $120.23 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $79.43 | $120.23 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $269.15 | Facility | None | $234.42 | $234.42 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $371.54 | Professional | None | $89.13 | $169.82 | $371.54 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $269.15 | Facility | None | $63.10 | $128.82 | $269.15 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $630.96 | Professional | None | $128.82 | $223.87 | $630.96 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $245.47 | Professional | None | $64.57 | $128.82 | $245.47 |
8 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 Facility Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $64.57 | Facility | 52 · Reduced service | $31.62 | $31.62 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $25.70 | Facility | 53 · Discontinued | $12.59 | $12.59 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $19.05 | Facility | 55 · Aftercare only | $9.33 | $9.33 | $19.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $12.88 | Facility | 56 · Pre-op care only | $6.31 | $6.31 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $41.69 Typical High $67.61 | Professional | 52 · Reduced service | $30.20 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $26.92 | Professional | 53 · Discontinued | $12.02 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.30 Typical High $20.42 | Professional | 55 · Aftercare only | $9.12 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $13.49 |
Where North Dakota sits
The same service costs 11.7 times more in Connecticut than in Delaware. 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
CT $2,806DE $240
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.