How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,122 to $6,761Professionalmedian $708 · 10th to 90th $562 to $1,072
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 $812.83 Median $3,162.28 Typical High $7,244.36 | Facility | None | $812.83 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $812.83 | Professional | None | $645.65 | $645.65 | $812.83 |
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 $616.60 Median $758.58 Typical High $1,380.38 | Professional | None | $616.60 | $758.58 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,311.31 Typical High $4,570.88 | Facility | None | $724.44 | $3,311.31 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $1,047.13 | Professional | None | $537.03 | $562.34 | $1,047.13 |
Hometown Health Setting Professional Modifier None Typical Low $9.77 Median $660.69 Typical High $1,000.00 | Professional | None | $9.77 | $660.69 | $1,000.00 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $851.14 | Professional | None | $8.32 | $8.32 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $4,265.80 | Facility | None | $575.44 | $575.44 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $575.44 Median $691.83 Typical High $1,071.52 | Professional | None | $575.44 | $691.83 | $1,071.52 |
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 $323.59 Median $323.59 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | 53 · Discontinued | $128.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $81.28 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $562.34 |
Where Nevada sits
The same service costs 5.1 times more in Wisconsin 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
WI $10,170MT $2,000
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.