How much rates vary
Facilitymedian $741 · 10th to 90th $135 to $3,802Professionalmedian $479 · 10th to 90th $380 to $759
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 $478.63 Median $1,698.24 Typical High $4,365.16 | Facility | None | $478.63 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $524.81 | Professional | None | $446.68 | $478.63 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $851.14 | Professional | None | $457.09 | $524.81 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $489.78 | Facility | None | $141.25 | $177.83 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $707.95 | Professional | None | $380.19 | $407.38 | $707.95 |
Hometown Health Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $776.25 | Professional | None | $316.23 | $489.78 | $776.25 |
Hometown Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $2.40 Median $213.80 Typical High $812.83 | Professional | None | $2.40 | $213.80 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $4,265.80 | Facility | None | $446.68 | $537.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $891.25 | Professional | None | $354.81 | $501.19 | $891.25 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $741.31 | Professional | None | $371.54 | $478.63 | $741.31 |
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 $223.87 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $223.87 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $309.03 | $338.84 | $354.81 |
Where Nevada sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.