How much rates vary
Facilitymedian $16,596 · 10th to 90th $2,630 to $51,286Professionalmedian $1,072 · 10th to 90th $776 to $1,862
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 $1,949.84 Median $5,495.41 Typical High $75,857.76 | Facility | None | $1,949.84 | $5,495.41 | $75,857.76 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $5,495.41 | Professional | None | $912.01 | $1,023.29 | $5,495.41 |
Ambetter Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,549.93 Median $19,952.62 Typical High $50,118.72 | Facility | None | $9,549.93 | $19,952.62 | $50,118.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,995.26 | Professional | None | $912.01 | $1,096.48 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $24,547.09 Typical High $36,307.81 | Facility | None | $758.58 | $24,547.09 | $36,307.81 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,513.56 | Professional | None | $776.25 | $812.83 | $1,513.56 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $1,000.00 Typical High $1,348.96 | Professional | None | $12.02 | $1,000.00 | $1,348.96 |
Hometown Health Setting Facility Modifier None Typical Low $25,703.96 Median $25,703.96 Typical High $25,703.96 | Facility | None | $25,703.96 | $25,703.96 | $25,703.96 |
Hometown Health Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $1,174.90 | Professional | None | $10.23 | $10.23 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $4,265.80 | Facility | None | $776.25 | $776.25 | $4,265.80 |
United Setting Facility Modifier None Typical Low $3,715.35 Median $16,595.87 Typical High $81,283.05 | Facility | None | $3,715.35 | $16,595.87 | $81,283.05 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,905.46 | Professional | None | $891.25 | $1,122.02 | $1,905.46 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Where Nevada sits
The same service costs 19.9 times more in Alaska 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
AK $53,750MT $2,699
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.