How much rates vary
Facilitymedian $741 · 10th to 90th $138 to $3,802Professionalmedian $214 · 10th to 90th $129 to $339
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 $141.25 Median $1,698.24 Typical High $4,365.16 | Facility | None | $141.25 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $269.15 | Professional | None | $141.25 | $223.87 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $363.08 | Professional | None | $128.82 | $218.78 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $489.78 | Facility | None | $144.54 | $177.83 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $316.23 | Professional | None | $112.20 | $173.78 | $316.23 |
Hometown Health Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $380.19 | Professional | None | $125.89 | $199.53 | $380.19 |
Hometown Health Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Hometown Health Setting Professional Modifier None Typical Low $1.07 Median $190.55 Typical High $371.54 | Professional | None | $1.07 | $190.55 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $4,265.80 | Facility | None | $125.89 | $251.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $323.59 | Professional | None | $134.90 | $213.80 | $323.59 |
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 $69.18 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $69.18 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $28.18 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $173.78 | Professional | 54 · Surgery only | $104.71 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $20.89 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $22.91 |
Where Nevada sits
The same service costs 8.8 times more in New York than in Alabama. 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
NY $2,761AL $314
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.