How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,122 to $5,495Professionalmedian $933 · 10th to 90th $692 to $1,445
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 $954.99 Median $3,162.28 Typical High $7,244.36 | Facility | None | $954.99 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $954.99 | Professional | None | $870.96 | $870.96 | $954.99 |
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 $891.25 Median $1,023.29 Typical High $1,621.81 | Professional | None | $891.25 | $1,023.29 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $2,511.89 | Facility | None | $724.44 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,348.96 | Professional | None | $724.44 | $776.25 | $1,348.96 |
Hometown Health Setting Professional Modifier None Typical Low $7.94 Median $776.25 Typical High $1,445.44 | Professional | None | $7.94 | $776.25 | $1,445.44 |
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 $1,258.93 | Professional | None | $6.03 | $6.03 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $4,265.80 | Facility | None | $831.76 | $831.76 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,698.24 | Professional | None | $676.08 | $831.76 | $1,698.24 |
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 $575.44 Median $912.01 Typical High $1,412.54 | Professional | None | $575.44 | $912.01 | $1,412.54 |
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 $436.52 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $660.69 |
Where Nevada sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.