How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,549 to $10,715Professionalmedian $933 · 10th to 90th $490 to $8,710
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 $537.03 Median $3,981.07 Typical High $6,165.95 | Facility | None | $537.03 | $3,981.07 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $3,981.07 Typical High $6,165.95 | Professional | None | $489.78 | $3,981.07 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $9,332.54 Typical High $12,022.64 | Facility | None | $4,570.88 | $9,332.54 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $933.25 | Professional | None | $501.19 | $575.44 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,073.80 Typical High $5,623.41 | Facility | None | $691.83 | $4,073.80 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $6,025.60 Typical High $9,120.11 | Professional | None | $446.68 | $6,025.60 | $9,120.11 |
Hometown Health Setting Professional Modifier None Typical Low $371.54 Median $1,148.15 Typical High $8,128.31 | Professional | None | $371.54 | $1,148.15 | $8,128.31 |
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 $7.76 Median $660.69 Typical High $8,709.64 | Professional | None | $7.76 | $660.69 | $8,709.64 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $4,265.80 Typical High $5,754.40 | Facility | None | $446.68 | $4,265.80 | $5,754.40 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $851.14 Typical High $5,495.41 | Professional | None | $354.81 | $851.14 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,162.28 | $6,456.54 |
United Setting Professional Modifier None Typical Low $537.03 Median $6,309.57 Typical High $10,715.19 | Professional | None | $537.03 | $6,309.57 | $10,715.19 |
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 $245.47 Median $398.11 Typical High $3,090.30 | Professional | 52 · Reduced service | $245.47 | $398.11 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $162.18 Typical High $1,258.93 | Professional | 53 · Discontinued | $97.72 | $162.18 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $602.56 Typical High $4,677.35 | Professional | 54 · Surgery only | $371.54 | $602.56 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $120.23 Typical High $933.25 | Professional | 55 · Aftercare only | $74.13 | $120.23 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $79.43 Typical High $616.60 | Professional | 56 · Pre-op care only | $48.98 | $79.43 | $616.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $562.34 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $346.74 | $562.34 | $4,365.16 |
Where Nevada sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,493
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.