How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,096 to $5,495Professionalmedian $794 · 10th to 90th $513 to $1,288
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 $794.33 Median $2,570.40 Typical High $6,165.95 | Facility | None | $794.33 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | None | $724.44 | $724.44 | $794.33 |
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 $741.31 Median $851.14 Typical High $1,380.38 | Professional | None | $741.31 | $851.14 | $1,380.38 |
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 $537.03 Median $776.25 Typical High $1,202.26 | Professional | None | $537.03 | $776.25 | $1,202.26 |
Hometown Health Setting Professional Modifier None Typical Low $7.94 Median $676.08 Typical High $1,148.15 | Professional | None | $7.94 | $676.08 | $1,148.15 |
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 $6.03 Median $6.03 Typical High $1,023.29 | Professional | None | $6.03 | $6.03 | $1,023.29 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $4,265.80 | Facility | None | $676.08 | $676.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,380.38 | Professional | None | $537.03 | $676.08 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $208.93 Median $794.33 Typical High $1,348.96 | Professional | None | $208.93 | $794.33 | $1,348.96 |
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 $363.08 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $549.54 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $562.34 |
Where Nevada sits
The same service costs 3.3 times more in Wisconsin than in Hawaii. 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
WI $7,931HI $2,400
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.