How much rates vary
Facilitymedian $2,188 · 10th to 90th $871 to $4,467Professionalmedian $468 · 10th to 90th $372 to $741
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 $478.63 Median $2,238.72 Typical High $5,128.61 | Facility | None | $478.63 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $676.08 | Professional | None | $457.09 | $457.09 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $954.99 | Professional | None | $426.58 | $512.86 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,548.82 Typical High $2,238.72 | Facility | None | $501.19 | $1,548.82 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $707.95 | Professional | None | $371.54 | $389.05 | $707.95 |
Hometown Health Setting Professional Modifier None Typical Low $3.72 Median $467.74 Typical High $660.69 | Professional | None | $3.72 | $467.74 | $660.69 |
Hometown Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Hometown Health Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $588.84 | Professional | None | $3.16 | $3.16 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $4,265.80 | Facility | None | $389.05 | $389.05 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $691.83 | Professional | None | $302.00 | $446.68 | $691.83 |
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 $223.87 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 53 · Discontinued | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $331.13 |
Where Nevada sits
The same service costs 4.1 times more in Oklahoma 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
OK $5,653MT $1,368
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.