How much rates vary
Facilitymedian $1,047 · 10th to 90th $110 to $3,981Professionalmedian $162 · 10th to 90th $91 to $269
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 $162.18 Median $1,698.24 Typical High $4,365.16 | Facility | None | $162.18 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $234.42 | Professional | None | $89.13 | $147.91 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $257.04 | Professional | None | $93.33 | $169.82 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $125.89 Typical High $199.53 | Facility | None | $109.65 | $125.89 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $263.03 | Professional | None | $87.10 | $147.91 | $263.03 |
Hometown Health Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $316.23 | Professional | None | $95.50 | $138.04 | $316.23 |
Hometown Health Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Hometown Health Setting Professional Modifier None Typical Low $1.38 Median $131.83 Typical High $316.23 | Professional | None | $1.38 | $131.83 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $87.10 Median $208.93 Typical High $4,265.80 | Facility | None | $87.10 | $208.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $288.40 | Professional | None | $97.72 | $173.78 | $288.40 |
5 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 $44.67 Median $69.18 Typical High $83.18 | Professional | 52 · Reduced service | $44.67 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $27.54 Typical High $33.88 | Professional | 53 · Discontinued | $17.78 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $104.71 Typical High $125.89 | Professional | 54 · Surgery only | $67.61 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $20.89 Typical High $25.12 | Professional | 55 · Aftercare only | $13.49 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.91 | $13.80 | $16.98 |
Where Nevada sits
The same service costs 11.6 times more in Hawaii than in Maryland. 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
HI $3,027MD $261
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.