How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,778 to $10,000Professionalmedian $6,026 · 10th to 90th $437 to $8,511
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 $457.09 Median $5,011.87 Typical High $7,413.10 | Facility | None | $457.09 | $5,011.87 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $4,466.84 Typical High $6,456.54 | Professional | None | $457.09 | $4,466.84 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,311.31 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $5,248.07 Typical High $8,912.51 | Professional | None | $436.52 | $5,248.07 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $8,128.31 Typical High $11,481.54 | Facility | None | $741.31 | $8,128.31 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $6,165.95 Typical High $7,943.28 | Professional | None | $389.05 | $6,165.95 | $7,943.28 |
Hometown Health Setting Professional Modifier None Typical Low $380.19 Median $6,025.60 Typical High $9,120.11 | Professional | None | $380.19 | $6,025.60 | $9,120.11 |
Hometown Health Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Hometown Health Setting Professional Modifier None Typical Low $7.08 Median $588.84 Typical High $12,022.64 | Professional | None | $7.08 | $588.84 | $12,022.64 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $4,265.80 Typical High $5,888.44 | Facility | None | $398.11 | $4,265.80 | $5,888.44 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $5,888.44 | Professional | None | $338.84 | $537.03 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $457.09 Median $6,309.57 Typical High $9,332.54 | Professional | None | $457.09 | $6,309.57 | $9,332.54 |
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 $229.09 Median $2,511.89 Typical High $3,235.94 | Professional | 52 · Reduced service | $229.09 | $2,511.89 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $1,023.29 Typical High $1,288.25 | Professional | 53 · Discontinued | $91.20 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $3,801.89 Typical High $4,786.30 | Professional | 54 · Surgery only | $346.74 | $3,801.89 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $758.58 Typical High $954.99 | Professional | 55 · Aftercare only | $69.18 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $512.86 Typical High $645.65 | Professional | 56 · Pre-op care only | $45.71 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $3,548.13 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $323.59 | $3,548.13 | $4,466.84 |
Where Nevada sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.