How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,445 to $10,000Professionalmedian $759 · 10th to 90th $575 to $1,259
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 $758.58 Median $3,162.28 Typical High $7,244.36 | Facility | None | $758.58 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $3,981.07 | Professional | None | $645.65 | $758.58 | $3,981.07 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $6,760.83 Typical High $12,589.25 | Facility | None | $3,235.94 | $6,760.83 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,445.44 | Professional | None | $645.65 | $794.33 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $5,011.87 | Facility | None | $724.44 | $3,467.37 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,148.15 | Professional | None | $575.44 | $645.65 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $10.96 Median $741.31 Typical High $1,023.29 | Professional | None | $10.96 | $741.31 | $1,023.29 |
Hometown Health Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $891.25 | Professional | None | $9.33 | $9.33 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $4,265.80 | Facility | None | $588.84 | $588.84 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $10,000.00 | Facility | None | $1,905.46 | $3,019.95 | $10,000.00 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,174.90 | Professional | None | $645.65 | $794.33 | $1,174.90 |
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 $371.54 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where Nevada sits
The same service costs 5.3 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 $10,556MT $2,002
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.