How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,122 to $5,495Professionalmedian $851 · 10th to 90th $631 to $1,288
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 $851.14 Median $3,162.28 Typical High $7,244.36 | Facility | None | $851.14 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | None | $776.25 | $776.25 | $851.14 |
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 $794.33 Median $912.01 Typical High $1,479.11 | Professional | None | $794.33 | $912.01 | $1,479.11 |
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 $602.56 Median $676.08 Typical High $1,202.26 | Professional | None | $602.56 | $676.08 | $1,202.26 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $724.44 Typical High $1,288.25 | Professional | None | $11.48 | $724.44 | $1,288.25 |
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 $8.71 Median $8.71 Typical High $1,122.02 | Professional | None | $8.71 | $8.71 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $4,265.80 | Facility | None | $741.31 | $741.31 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,513.56 | Professional | None | $602.56 | $741.31 | $1,513.56 |
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 $630.96 Median $812.83 Typical High $1,258.93 | Professional | None | $630.96 | $812.83 | $1,258.93 |
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 $389.05 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $602.56 |
Where Nevada sits
The same service costs 3.1 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 $8,115MD $2,591
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.