How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,514 to $6,166Professionalmedian $692 · 10th to 90th $562 to $1,072
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 $3,981.07 Typical High $10,715.19 | Facility | None | $630.96 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | None | $630.96 | $630.96 | $691.83 |
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 $645.65 Median $741.31 Typical High $1,202.26 | Professional | None | $645.65 | $741.31 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,819.70 Typical High $2,511.89 | Facility | None | $741.31 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,047.13 | Professional | None | $562.34 | $630.96 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $15.49 Median $588.84 Typical High $1,023.29 | Professional | None | $15.49 | $588.84 | $1,023.29 |
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 $11.75 Median $11.75 Typical High $891.25 | Professional | None | $11.75 | $11.75 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $4,265.80 | Facility | None | $588.84 | $588.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,202.26 | Professional | None | $467.74 | $588.84 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,047.13 | Professional | None | $575.44 | $676.08 | $1,047.13 |
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 $316.23 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 53 · Discontinued | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $489.78 |
Where Nevada sits
The same service costs 7.6 times more in Oklahoma than in Texas. 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
OK $11,248TX $1,472
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.