How much rates vary
Facilitymedian $1,585 · 10th to 90th $501 to $4,365Professionalmedian $295 · 10th to 90th $245 to $417
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 $295.12 Median $2,238.72 Typical High $5,128.61 | Facility | None | $295.12 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $5,128.61 | Facility | None | $1,096.48 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $512.86 | Professional | None | $275.42 | $316.23 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $1,380.38 | Facility | None | $537.03 | $977.24 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $416.87 | Professional | None | $257.04 | $257.04 | $416.87 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $269.15 Typical High $380.19 | Professional | None | $7.59 | $269.15 | $380.19 |
Hometown Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Hometown Health Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $371.54 | Professional | None | $5.75 | $5.75 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $4,265.80 | Facility | None | $245.47 | $245.47 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $512.86 | Professional | None | $173.78 | $223.87 | $512.86 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $398.11 | Professional | None | $245.47 | $295.12 | $398.11 |
5 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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Where Nevada sits
The same service costs 5.2 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 $4,508MT $873
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.