How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,380 to $5,495Professionalmedian $933 · 10th to 90th $646 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 $933.25 Median $2,570.40 Typical High $6,165.95 | Facility | None | $933.25 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | None | $851.14 | $851.14 | $933.25 |
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 $870.96 Median $1,000.00 Typical High $1,621.81 | Professional | None | $870.96 | $1,000.00 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Hometown Health Setting Professional Modifier None Typical Low $9.55 Median $758.58 Typical High $1,412.54 | Professional | None | $9.55 | $758.58 | $1,412.54 |
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 $7.24 Median $7.24 Typical High $1,230.27 | Professional | None | $7.24 | $7.24 | $1,230.27 |
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 $660.69 Median $831.76 Typical High $1,659.59 | Professional | None | $660.69 | $831.76 | $1,659.59 |
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 $645.65 Median $870.96 Typical High $1,380.38 | Professional | None | $645.65 | $870.96 | $1,380.38 |
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 $426.58 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $645.65 |
Where Nevada sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.