How much rates vary
Facilitymedian $1,047 · 10th to 90th $102 to $3,981Professionalmedian $105 · 10th to 90th $74 to $174
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 $97.72 Median $1,698.24 Typical High $4,365.16 | Facility | None | $97.72 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $128.82 | Professional | None | $89.13 | $117.49 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $169.82 | Professional | None | $91.20 | $104.71 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $177.83 | Facility | None | $100.00 | $114.82 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $169.82 | Professional | None | $74.13 | $104.71 | $169.82 |
Hometown Health Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $186.21 | Professional | None | $61.66 | $114.82 | $186.21 |
Hometown Health Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Hometown Health Setting Professional Modifier None Typical Low $0.95 Median $151.36 Typical High $223.87 | Professional | None | $0.95 | $151.36 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $147.91 Typical High $4,265.80 | Facility | None | $100.00 | $147.91 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $199.53 | Professional | None | $79.43 | $123.03 | $199.53 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $186.21 | Professional | None | $70.79 | $104.71 | $186.21 |
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 $44.67 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $44.67 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $67.61 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $13.49 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.91 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $77.62 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $63.10 | $77.62 | $85.11 |
Where Nevada sits
The same service costs 13.1 times more in Hawaii 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
HI $2,944MD $224
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.