How much rates vary
Facilitymedian $2,399 · 10th to 90th $912 to $5,495Professionalmedian $501 · 10th to 90th $372 to $776
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 $512.86 Median $2,570.40 Typical High $6,165.95 | Facility | None | $512.86 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | None | $457.09 | $457.09 | $512.86 |
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 $478.63 Median $549.54 Typical High $870.96 | Professional | None | $478.63 | $549.54 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,819.70 Typical High $2,511.89 | Facility | None | $616.60 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $707.95 | Professional | None | $398.11 | $407.38 | $707.95 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $426.58 Typical High $741.31 | Professional | None | $4.79 | $426.58 | $741.31 |
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 $3.63 Median $3.63 Typical High $660.69 | Professional | None | $3.63 | $3.63 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $4,265.80 | Facility | None | $436.52 | $436.52 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $870.96 | Professional | None | $346.74 | $436.52 | $870.96 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $724.44 | Professional | None | $331.13 | $478.63 | $724.44 |
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 $229.09 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 54 · Surgery only | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $354.81 |
Where Nevada sits
The same service costs 4.6 times more in Alabama 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
AL $7,006MT $1,517
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.