How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,738 to $19,055Professionalmedian $1,202 · 10th to 90th $955 to $1,862
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 $1,202.26 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,202.26 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,096.48 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $5,754.40 Typical High $23,988.33 | Facility | None | $2,754.23 | $5,754.40 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,288.25 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $10,000.00 Typical High $15,488.17 | Facility | None | $741.31 | $10,000.00 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,949.84 | Professional | None | $954.99 | $954.99 | $1,949.84 |
Hometown Health Setting Professional Modifier None Typical Low $21.38 Median $1,023.29 Typical High $1,778.28 | Professional | None | $21.38 | $1,023.29 | $1,778.28 |
Hometown Health Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Hometown Health Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $1,513.56 | Professional | None | $16.22 | $16.22 | $1,513.56 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $4,265.80 | Facility | None | $1,023.29 | $1,023.29 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $2,089.30 | Professional | None | $812.83 | $1,023.29 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $11,481.54 | Facility | None | $1,905.46 | $3,162.28 | $11,481.54 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,778.28 | Professional | None | $977.24 | $1,202.26 | $1,778.28 |
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 $549.54 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $549.54 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $851.14 |
Where Nevada sits
The same service costs 10.4 times more in Alaska than in Kentucky. 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
AK $29,118KY $2,808
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.