How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,122 to $5,495Professionalmedian $661 · 10th to 90th $550 to $1,000
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 $2,570.40 Typical High $6,165.95 | Facility | None | $630.96 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | None | $575.44 | $575.44 | $630.96 |
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 $588.84 Median $676.08 Typical High $1,122.02 | Professional | None | $588.84 | $676.08 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,819.70 Typical High $2,630.27 | Facility | None | $616.60 | $1,819.70 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,023.29 | Professional | None | $549.54 | $549.54 | $1,023.29 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $537.03 Typical High $933.25 | Professional | None | $11.48 | $537.03 | $933.25 |
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 $8.51 Median $8.51 Typical High $794.33 | Professional | None | $8.51 | $8.51 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $4,265.80 | Facility | None | $537.03 | $537.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $1,096.48 | Professional | None | $426.58 | $537.03 | $1,096.48 |
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 $549.54 Median $660.69 Typical High $977.24 | Professional | None | $549.54 | $660.69 | $977.24 |
7 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 $288.40 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $436.52 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 50 · Both sides | $758.58 | $758.58 | $758.58 |
Where Nevada sits
The same service costs 4.2 times more in Wisconsin than in Montana. 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 $7,788MT $1,867
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.