How much rates vary
Facilitymedian $8,128 · 10th to 90th $1,995 to $26,303Professionalmedian $1,995 · 10th to 90th $1,585 to $3,020
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 $1,995.26 Median $4,570.88 Typical High $10,715.19 | Facility | None | $1,995.26 | $4,570.88 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,819.70 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $11,220.18 Typical High $26,302.68 | Facility | None | $4,897.79 | $11,220.18 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,089.30 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $21,877.62 Typical High $31,622.78 | Facility | None | $691.83 | $21,877.62 | $31,622.78 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,698.24 | $2,691.53 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $1,479.11 Typical High $2,884.03 | Professional | None | $28.18 | $1,479.11 | $2,884.03 |
Hometown Health Setting Facility Modifier None Typical Low $21,877.62 Median $21,877.62 Typical High $21,877.62 | Facility | None | $21,877.62 | $21,877.62 | $21,877.62 |
Hometown Health Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $2,454.71 | Professional | None | $20.89 | $20.89 | $2,454.71 |
Select Health Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $4,265.80 | Facility | None | $1,659.59 | $1,659.59 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $4,265.80 | Professional | None | $1,318.26 | $1,659.59 | $4,265.80 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,079.46 Typical High $14,454.40 | Facility | None | $3,019.95 | $7,079.46 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,584.89 | $2,089.30 | $2,951.21 |
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 $912.01 Median $912.01 Typical High $1,000.00 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 53 · Discontinued | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,412.54 |
Where Nevada sits
The same service costs 8.7 times more in Alaska 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
AK $35,597KY $4,069
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.