How much rates vary
Facilitymedian $1,862 · 10th to 90th $468 to $5,012Professionalmedian $316 · 10th to 90th $209 to $513
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 $218.78 Median $2,238.72 Typical High $5,011.87 | Facility | None | $218.78 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $338.84 | Professional | None | $194.98 | $263.03 | $338.84 |
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 $218.78 Median $346.74 Typical High $524.81 | Professional | None | $218.78 | $346.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $1,737.80 | Facility | None | $630.96 | $1,288.25 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $407.38 | Professional | None | $177.83 | $269.15 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $1,288.25 | Professional | None | $213.80 | $331.13 | $1,288.25 |
Hometown Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $3.02 Median $288.40 Typical High $1,778.28 | Professional | None | $3.02 | $288.40 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $4,265.80 | Facility | None | $194.98 | $354.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $467.74 | Professional | None | $229.09 | $323.59 | $467.74 |
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 $104.71 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $41.69 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $257.04 | Professional | 54 · Surgery only | $158.49 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $51.29 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $33.88 |
Where Nevada sits
The same service costs 6.1 times more in Michigan 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
MI $4,783MT $790
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.