How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,514 to $6,166Professionalmedian $708 · 10th to 90th $525 to $1,096
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 $724.44 Median $3,981.07 Typical High $8,128.31 | Facility | None | $724.44 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $812.83 | Professional | None | $660.69 | $660.69 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $467.74 | Professional | None | $64.57 | $64.57 | $467.74 |
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 $676.08 Median $776.25 Typical High $1,230.27 | Professional | None | $676.08 | $776.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,819.70 Typical High $2,951.21 | Facility | None | $794.33 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $1,000.00 | Professional | None | $524.81 | $562.34 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $8.71 Median $616.60 Typical High $1,071.52 | Professional | None | $8.71 | $616.60 | $1,071.52 |
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 $6.61 Median $6.61 Typical High $954.99 | Professional | None | $6.61 | $6.61 | $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 $501.19 Median $630.96 Typical High $1,258.93 | Professional | None | $501.19 | $630.96 | $1,258.93 |
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 $501.19 Median $676.08 Typical High $1,047.13 | Professional | None | $501.19 | $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 $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 $131.83 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $501.19 |
Where Nevada sits
The same service costs 4.6 times more in Connecticut 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
CT $10,009MT $2,168
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.