How much rates vary
Facilitymedian $3,715 · 10th to 90th $776 to $9,120Professionalmedian $676 · 10th to 90th $437 to $1,349
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 $562.34 Median $602.56 Typical High $1,000.00 | Professional | None | $562.34 | $602.56 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $14,125.38 | Facility | None | $2,754.23 | $4,168.69 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $851.14 | Professional | None | $457.09 | $630.96 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $933.25 Typical High $1,258.93 | Professional | 50 · Both sides | $691.83 | $933.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,949.84 Typical High $2,398.83 | Facility | None | $549.54 | $1,949.84 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $977.24 Typical High $1,659.59 | Professional | None | $501.19 | $977.24 | $1,659.59 |
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 $851.14 Median $1,148.15 Typical High $1,737.80 | Professional | None | $851.14 | $1,148.15 | $1,737.80 |
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 $316.23 Median $676.08 Typical High $1,819.70 | Professional | None | $316.23 | $676.08 | $1,819.70 |
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 $281.84 Median $295.12 Typical High $501.19 | Professional | 52 · Reduced service | $281.84 | $295.12 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $117.49 Typical High $199.53 | Professional | 53 · Discontinued | $114.82 | $117.49 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $758.58 | Professional | 54 · Surgery only | $426.58 | $446.68 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $151.36 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $100.00 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $707.95 |
Where Connecticut sits
The same service costs 3.2 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 $4,968MT $1,567
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.