How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,047 to $5,495Professionalmedian $490 · 10th to 90th $324 to $776
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 $501.19 Median $4,897.79 Typical High $8,128.31 | Facility | None | $501.19 | $4,897.79 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | None | $457.09 | $457.09 | $524.81 |
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 $467.74 Median $549.54 Typical High $870.96 | Professional | None | $467.74 | $549.54 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $2,511.89 | Facility | None | $1,096.48 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $707.95 | Professional | None | $316.23 | $389.05 | $707.95 |
Hometown Health Setting Professional Modifier None Typical Low $2.95 Median $407.38 Typical High $758.58 | Professional | None | $2.95 | $407.38 | $758.58 |
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 $2.24 Median $2.24 Typical High $676.08 | Professional | None | $2.24 | $2.24 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $4,265.80 | Facility | None | $446.68 | $446.68 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $912.01 | Professional | None | $363.08 | $446.68 | $912.01 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $724.44 | Professional | None | $281.84 | $478.63 | $724.44 |
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 $229.09 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 54 · Surgery only | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $354.81 |
Where Nevada sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.