How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,096 to $5,495Professionalmedian $617 · 10th to 90th $437 to $977
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 $602.56 Median $2,570.40 Typical High $6,165.95 | Facility | None | $602.56 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | None | $549.54 | $549.54 | $602.56 |
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 $562.34 Median $645.65 Typical High $1,023.29 | Professional | None | $562.34 | $645.65 | $1,023.29 |
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 $478.63 Median $616.60 Typical High $977.24 | Professional | None | $478.63 | $616.60 | $977.24 |
Hometown Health Setting Professional Modifier None Typical Low $5.25 Median $501.19 Typical High $933.25 | Professional | None | $5.25 | $501.19 | $933.25 |
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 $3.98 Median $3.98 Typical High $794.33 | Professional | None | $3.98 | $3.98 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $4,265.80 | Facility | None | $524.81 | $524.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $1,071.52 | Professional | None | $426.58 | $524.81 | $1,071.52 |
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 $389.05 Median $630.96 Typical High $1,047.13 | Professional | None | $389.05 | $630.96 | $1,047.13 |
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 $269.15 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $416.87 |
Where Nevada sits
The same service costs 4.1 times more in Oklahoma 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
OK $7,594MT $1,845
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.