How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,288 to $5,754Professionalmedian $1,479 · 10th to 90th $1,175 to $2,455
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 $1,288.25 Median $3,981.07 Typical High $5,248.07 | Facility | None | $1,288.25 | $3,981.07 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,659.59 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,311.31 Typical High $4,570.88 | Facility | None | $794.33 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,230.27 | $2,187.76 |
Hometown Health Setting Professional Modifier None Typical Low $977.24 Median $1,659.59 Typical High $3,801.89 | Professional | None | $977.24 | $1,659.59 | $3,801.89 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $8.32 Median $1,548.82 Typical High $4,786.30 | Professional | None | $8.32 | $1,548.82 | $4,786.30 |
Select Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $4,265.80 | Facility | None | $1,023.29 | $1,479.11 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,479.11 | $2,290.87 |
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 $630.96 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,096.48 |
Where Nevada sits
The same service costs 3.2 times more in Alaska 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
AK $12,311KY $3,892
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.