How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,122 to $5,495Professionalmedian $724 · 10th to 90th $562 to $1,148
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 $2,570.40 Typical High $6,165.95 | Facility | None | $724.44 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | None | $660.69 | $660.69 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $1,258.93 | Professional | None | $676.08 | $776.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,819.70 Typical High $2,691.53 | Facility | None | $616.60 | $1,819.70 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,174.90 | Professional | None | $562.34 | $588.84 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $15.49 Median $630.96 Typical High $1,096.48 | Professional | None | $15.49 | $630.96 | $1,096.48 |
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 $11.48 Median $11.48 Typical High $954.99 | Professional | None | $11.48 | $11.48 | $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 $1,288.25 | Professional | None | $501.19 | $630.96 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,778.28 | $4,073.80 |
United Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,096.48 | Professional | None | $602.56 | $724.44 | $1,096.48 |
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 $134.90 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $109.65 |
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 $467.74 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $512.86 |
Where Nevada sits
The same service costs 3.6 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 $7,904MT $2,218
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.