How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,122 to $5,495Professionalmedian $617 · 10th to 90th $468 to $813
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 $645.65 Median $3,162.28 Typical High $7,244.36 | Facility | None | $645.65 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $588.84 Median $676.08 Typical High $1,096.48 | Professional | None | $588.84 | $676.08 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $2,630.27 | Facility | None | $724.44 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $794.33 | Professional | None | $436.52 | $489.78 | $794.33 |
Hometown Health Setting Professional Modifier None Typical Low $7.08 Median $562.34 Typical High $794.33 | Professional | None | $7.08 | $562.34 | $794.33 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $831.76 | Professional | None | $5.25 | $5.25 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $4,265.80 | Facility | None | $562.34 | $562.34 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $1,122.02 | Professional | None | $371.54 | $512.86 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $776.25 | Professional | None | $478.63 | $575.44 | $776.25 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Where Nevada sits
The same service costs 4.0 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 $7,771MT $1,932
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.