How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,413 to $9,772Professionalmedian $1,318 · 10th to 90th $891 to $6,918
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 $2,454.71 Median $3,981.07 Typical High $7,585.78 | Facility | None | $2,454.71 | $3,981.07 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,621.81 | Professional | None | $891.25 | $1,000.00 | $1,621.81 |
BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,621.81 | $4,897.79 | $10,471.29 |
BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $2,454.71 | Professional | None | $977.24 | $1,318.26 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $5,370.32 Typical High $11,220.18 | Facility | None | $831.76 | $5,370.32 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,862.09 | Professional | None | $851.14 | $1,071.52 | $1,862.09 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,918.31 | Professional | None | $6,606.93 | $6,606.93 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,570.88 Typical High $8,912.51 | Facility | None | $1,548.82 | $4,570.88 | $8,912.51 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,041.74 | Professional | None | $851.14 | $1,288.25 | $2,041.74 |
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 $446.68 Median $501.19 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $177.83 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $660.69 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $131.83 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $851.14 |
Where Tennessee sits
The same service costs 4.6 times more in Wyoming 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
WY $13,103MT $2,825
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.