How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,349 to $12,303Professionalmedian $724 · 10th to 90th $575 to $1,148
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 $741.31 Median $3,162.28 Typical High $7,244.36 | Facility | None | $741.31 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | None | $660.69 | $660.69 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $11,220.18 | Facility | None | $4,897.79 | $8,128.31 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $10,000.00 Typical High $14,125.38 | Facility | None | $724.44 | $10,000.00 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,071.52 | Professional | None | $575.44 | $616.60 | $1,071.52 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $588.84 Typical High $1,071.52 | Professional | None | $3.63 | $588.84 | $1,071.52 |
Hometown Health Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $954.99 | Professional | None | $2.69 | $2.69 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $4,265.80 | Facility | None | $630.96 | $630.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,288.25 | Professional | None | $512.86 | $630.96 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $11,481.54 | Facility | None | $1,905.46 | $3,090.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,122.02 | Professional | None | $602.56 | $707.95 | $1,122.02 |
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 $331.13 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $512.86 |
Where Nevada sits
The same service costs 11.8 times more in Alaska than in West Virginia. 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 $23,236WV $1,973
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.