How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,096 to $5,495Professionalmedian $676 · 10th to 90th $537 to $1,047
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 $676.08 Median $2,570.40 Typical High $6,165.95 | Facility | None | $676.08 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | None | $616.60 | $616.60 | $676.08 |
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 $630.96 Median $741.31 Typical High $1,174.90 | Professional | None | $630.96 | $741.31 | $1,174.90 |
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 $562.34 Typical High $1,000.00 | Professional | None | $537.03 | $562.34 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $6.76 Median $575.44 Typical High $1,000.00 | Professional | None | $6.76 | $575.44 | $1,000.00 |
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 $5.13 Median $5.13 Typical High $891.25 | Professional | None | $5.13 | $5.13 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $4,265.80 | Facility | None | $588.84 | $588.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,202.26 | Professional | None | $467.74 | $588.84 | $1,202.26 |
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 $562.34 Median $660.69 Typical High $1,000.00 | Professional | None | $562.34 | $660.69 | $1,000.00 |
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 $309.03 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $478.63 |
Where Nevada sits
The same service costs 3.7 times more in Wisconsin 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
WI $7,647MT $2,070
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.