How much rates vary
Facilitymedian $4,786 · 10th to 90th $759 to $13,804Professionalmedian $1,259 · 10th to 90th $759 to $1,778
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 $794.33 Median $1,202.26 Typical High $1,445.44 | Professional | None | $794.33 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $16,218.10 | Facility | None | $4,786.30 | $8,317.64 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,380.38 Typical High $1,737.80 | Professional | None | $776.25 | $1,380.38 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,995.26 Typical High $2,630.27 | Professional | 50 · Both sides | $1,148.15 | $1,995.26 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $5,623.41 | Facility | None | $549.54 | $4,466.84 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,819.70 | Professional | None | $660.69 | $1,000.00 | $1,819.70 |
ConnectiCare Setting Facility Modifier None Typical Low $331.13 Median $562.34 Typical High $2,187.76 | Facility | None | $331.13 | $562.34 | $2,187.76 |
ConnectiCare Setting Professional Modifier None Typical Low $537.03 Median $870.96 Typical High $1,230.27 | Professional | None | $537.03 | $870.96 | $1,230.27 |
Health New England Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
Health New England Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $691.83 Median $954.99 Typical High $2,570.40 | Professional | None | $691.83 | $954.99 | $2,570.40 |
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 $446.68 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $446.68 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $660.69 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $831.76 | $831.76 |
Where Connecticut sits
The same service costs 5.4 times more in Alaska than in South Carolina. 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 $8,807SC $1,633
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.