How much rates vary
Facilitymedian $2,399 · 10th to 90th $912 to $5,495Professionalmedian $603 · 10th to 90th $407 to $955
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 $630.96 Median $3,162.28 Typical High $7,244.36 | Facility | None | $630.96 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | None | $575.44 | $575.44 | $630.96 |
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 $588.84 Median $676.08 Typical High $1,096.48 | Professional | None | $588.84 | $676.08 | $1,096.48 |
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 $363.08 Median $501.19 Typical High $870.96 | Professional | None | $363.08 | $501.19 | $870.96 |
Hometown Health Setting Professional Modifier None Typical Low $5.25 Median $537.03 Typical High $954.99 | Professional | None | $5.25 | $537.03 | $954.99 |
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 $3.98 Median $3.98 Typical High $831.76 | Professional | None | $3.98 | $3.98 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $4,265.80 | Facility | None | $562.34 | $562.34 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,122.02 | Professional | None | $446.68 | $562.34 | $1,122.02 |
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 $363.08 Median $588.84 Typical High $891.25 | Professional | None | $363.08 | $588.84 | $891.25 |
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 $288.40 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $446.68 |
Where Nevada sits
The same service costs 4.4 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 $8,454MT $1,932
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.