How much rates vary
Facilitymedian $4,169 · 10th to 90th $813 to $7,943Professionalmedian $324 · 10th to 90th $200 to $562
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 $295.12 Median $302.00 Typical High $501.19 | Professional | None | $295.12 | $302.00 | $501.19 |
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 $229.09 Median $323.59 Typical High $426.58 | Professional | None | $229.09 | $323.59 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $478.63 Typical High $616.60 | Professional | 50 · Both sides | $346.74 | $478.63 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,238.72 Typical High $2,951.21 | Facility | None | $741.31 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $323.59 Typical High $676.08 | Professional | None | $162.18 | $323.59 | $676.08 |
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 $245.47 Median $407.38 Typical High $549.54 | Professional | None | $245.47 | $407.38 | $549.54 |
Health New England Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | None | $478.63 | $478.63 | $602.56 |
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 $363.08 Typical High $1,000.00 | Professional | None | $190.55 | $363.08 | $1,000.00 |
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 $147.91 Median $147.91 Typical High $251.19 | Professional | 52 · Reduced service | $147.91 | $147.91 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $100.00 | Professional | 53 · Discontinued | $58.88 | $58.88 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $380.19 | Professional | 54 · Surgery only | $218.78 | $218.78 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $75.86 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $50.12 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $354.81 |
Where Connecticut sits
The same service costs 6.3 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 $4,654MT $736
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.