How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,230 to $10,000Professionalmedian $741 · 10th to 90th $389 to $2,291
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 $426.58 Median $3,162.28 Typical High $5,011.87 | Facility | None | $426.58 | $3,162.28 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $1,659.59 Typical High $1,949.84 | Professional | None | $389.05 | $1,659.59 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $9,332.54 Typical High $12,022.64 | Facility | None | $2,754.23 | $9,332.54 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $741.31 | Professional | None | $398.11 | $457.09 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,819.70 Typical High $2,511.89 | Facility | None | $741.31 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,412.54 Typical High $2,187.76 | Professional | None | $346.74 | $1,412.54 | $2,187.76 |
Hometown Health Setting Professional Modifier None Typical Low $288.40 Median $1,202.26 Typical High $2,398.83 | Professional | None | $288.40 | $1,202.26 | $2,398.83 |
Hometown Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $5.50 Median $537.03 Typical High $2,630.27 | Professional | None | $5.50 | $537.03 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $1,778.28 Typical High $4,265.80 | Facility | None | $354.81 | $1,778.28 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $676.08 Typical High $1,698.24 | Professional | None | $281.84 | $676.08 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $4,897.79 | Facility | None | $1,174.90 | $1,778.28 | $4,897.79 |
United Setting Professional Modifier None Typical Low $426.58 Median $1,479.11 Typical High $2,570.40 | Professional | None | $426.58 | $1,479.11 | $2,570.40 |
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 $194.98 Median $316.23 Typical High $891.25 | Professional | 52 · Reduced service | $194.98 | $316.23 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $125.89 Typical High $354.81 | Professional | 53 · Discontinued | $77.62 | $125.89 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $467.74 Typical High $1,479.11 | Professional | 54 · Surgery only | $288.40 | $467.74 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $93.33 Typical High $269.15 | Professional | 55 · Aftercare only | $57.54 | $93.33 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $63.10 Typical High $177.83 | Professional | 56 · Pre-op care only | $38.90 | $63.10 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $436.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $269.15 | $436.52 | $1,230.27 |
Where Nevada sits
The same service costs 4.4 times more in Oklahoma 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
OK $10,373MD $2,367
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.