How much rates vary
Facilitymedian $1,318 · 10th to 90th $468 to $4,467Professionalmedian $295 · 10th to 90th $209 to $479
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 $239.88 Median $2,238.72 Typical High $5,011.87 | Facility | None | $239.88 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $436.52 | Professional | None | $213.80 | $275.42 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $478.63 | Professional | None | $245.47 | $338.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,122.02 | Facility | None | $501.19 | $812.83 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $416.87 | Professional | None | $204.17 | $257.04 | $416.87 |
Hometown Health Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $851.14 | Professional | None | $245.47 | $346.74 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $1.45 Median $338.84 Typical High $1,174.90 | Professional | None | $1.45 | $338.84 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $4,265.80 | Facility | None | $223.87 | $331.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $426.58 | Professional | None | $199.53 | $281.84 | $426.58 |
7 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 $114.82 Median $125.89 Typical High $154.88 | Professional | 52 · Reduced service | $114.82 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $50.12 Typical High $61.66 | Professional | 53 · Discontinued | $45.71 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $234.42 | Professional | 54 · Surgery only | $173.78 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.02 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.12 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.91 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $218.78 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 59 · Distinct service | $302.00 | $302.00 | $302.00 |
Where Nevada sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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.
Nevada· 33rd of 51
$324
AK $1,202KY $251
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.