How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,445 to $6,166Professionalmedian $891 · 10th to 90th $676 to $1,413
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 $912.01 Median $2,570.40 Typical High $6,165.95 | Facility | None | $912.01 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | None | $831.76 | $831.76 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,584.89 | Professional | None | $851.14 | $977.24 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,073.80 Typical High $5,888.44 | Facility | None | $741.31 | $4,073.80 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,288.25 | Professional | None | $616.60 | $776.25 | $1,288.25 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $794.33 Typical High $1,445.44 | Professional | None | $9.33 | $794.33 | $1,445.44 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $1,288.25 | Professional | None | $7.08 | $7.08 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $4,265.80 | Facility | None | $851.14 | $851.14 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,737.80 | Professional | None | $676.08 | $851.14 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,318.26 | Professional | None | $676.08 | $870.96 | $1,318.26 |
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 $416.87 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $645.65 |
Where Nevada sits
The same service costs 5.1 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,738KY $2,311
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.