How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,047 to $13,490Professionalmedian $741 · 10th to 90th $562 to $1,230
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 $954.99 Median $3,981.07 Typical High $10,715.19 | Facility | None | $954.99 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,047.13 | Professional | None | $562.34 | $851.14 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $12,589.25 Typical High $16,595.87 | Facility | None | $8,317.64 | $12,589.25 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,071.52 | Professional | None | $575.44 | $660.69 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,011.87 Typical High $7,079.46 | Facility | None | $794.33 | $5,011.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,258.93 | Professional | None | $562.34 | $741.31 | $1,258.93 |
Hometown Health Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,862.09 | Professional | None | $457.09 | $741.31 | $1,862.09 |
Hometown Health Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $831.76 Typical High $7,413.10 | Professional | None | $7.59 | $831.76 | $7,413.10 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $1,023.29 Typical High $4,265.80 | Facility | None | $562.34 | $1,023.29 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $1,047.13 | Professional | None | $446.68 | $831.76 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,168.69 | Facility | None | $1,202.26 | $1,862.09 | $4,168.69 |
United Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,318.26 | Professional | None | $602.56 | $851.14 | $1,318.26 |
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 $281.84 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $281.84 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $181.97 Typical High $194.98 | Professional | 53 · Discontinued | $112.20 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $416.87 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $83.18 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $56.23 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $389.05 | $630.96 | $676.08 |
Where Nevada sits
The same service costs 5.1 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 $10,217WV $2,002
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.