How much rates vary
Facilitymedian $2,884 · 10th to 90th $457 to $6,166Professionalmedian $417 · 10th to 90th $331 to $724
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 $416.87 Median $1,698.24 Typical High $4,365.16 | Facility | None | $416.87 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $524.81 | Professional | None | $346.74 | $416.87 | $524.81 |
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 $331.13 Median $457.09 Typical High $724.44 | Professional | None | $331.13 | $457.09 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $5,248.07 Typical High $7,585.78 | Facility | None | $398.11 | $5,248.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $676.08 | Professional | None | $281.84 | $346.74 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $6,309.57 | Professional | None | $295.12 | $446.68 | $6,309.57 |
Hometown Health Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Hometown Health Setting Professional Modifier None Typical Low $4.68 Median $446.68 Typical High $7,762.47 | Professional | None | $4.68 | $446.68 | $7,762.47 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $426.58 Typical High $4,265.80 | Facility | None | $295.12 | $426.58 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $309.03 Median $426.58 Typical High $707.95 | Professional | None | $309.03 | $426.58 | $707.95 |
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 $173.78 Median $208.93 Typical High $257.04 | Professional | 52 · Reduced service | $173.78 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $83.18 Typical High $104.71 | Professional | 53 · Discontinued | $69.18 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $316.23 Typical High $389.05 | Professional | 54 · Surgery only | $257.04 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $63.10 Typical High $77.62 | Professional | 55 · Aftercare only | $51.29 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $52.48 |
Where Nevada sits
The same service costs 9.3 times more in Wyoming 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
WY $10,585DE $1,135
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.