How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,175 to $5,495Professionalmedian $1,479 · 10th to 90th $1,096 to $2,239
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 $1,479.11 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,380.38 | $1,479.11 | $1,778.28 |
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 $1,288.25 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,584.89 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,311.31 Typical High $4,786.30 | Facility | None | $691.83 | $3,311.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $2,187.76 | Professional | None | $776.25 | $1,122.02 | $2,187.76 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $1,479.11 Typical High $2,041.74 | Professional | None | $11.48 | $1,479.11 | $2,041.74 |
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 $10.00 Median $10.00 Typical High $1,778.28 | Professional | None | $10.00 | $10.00 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $4,265.80 | Facility | None | $1,174.90 | $1,174.90 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,677.35 | Facility | None | $1,174.90 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,344.23 | Professional | None | $758.58 | $1,412.54 | $2,344.23 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,047.13 |
Where Nevada sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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
AL $18,462KY $2,797
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.