How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $7,943Professionalmedian $661 · 10th to 90th $363 to $1,023
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 $436.52 Median $676.08 Typical High $676.08 | Professional | None | $436.52 | $676.08 | $676.08 |
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 $354.81 Median $691.83 Typical High $912.01 | Professional | None | $354.81 | $691.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,570.40 | Facility | None | $741.31 | $1,995.26 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,148.15 | Professional | None | $575.44 | $616.60 | $1,148.15 |
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 $489.78 Median $588.84 Typical High $707.95 | Professional | None | $489.78 | $588.84 | $707.95 |
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 $575.44 Typical High $1,202.26 | Professional | None | $316.23 | $575.44 | $1,202.26 |
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 $229.09 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $229.09 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $91.20 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $346.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $69.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $45.71 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $323.59 | $478.63 | $478.63 |
Where Connecticut sits
The same service costs 3.9 times more in Oklahoma 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
OK $5,276MT $1,369
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.