How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,096 to $5,012Professionalmedian $355 · 10th to 90th $275 to $562
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 $346.74 Median $2,570.40 Typical High $6,165.95 | Facility | None | $346.74 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $489.78 | Professional | None | $346.74 | $346.74 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $691.83 | Professional | None | $323.59 | $389.05 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,905.46 Typical High $2,630.27 | Facility | None | $616.60 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $537.03 | Professional | None | $275.42 | $295.12 | $537.03 |
Hometown Health Setting Professional Modifier None Typical Low $5.37 Median $338.84 Typical High $524.81 | Professional | None | $5.37 | $338.84 | $524.81 |
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 $4.57 Median $4.57 Typical High $457.09 | Professional | None | $4.57 | $4.57 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $4,265.80 | Facility | None | $302.00 | $302.00 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $302.00 Median $389.05 Typical High $549.54 | Professional | None | $302.00 | $389.05 | $549.54 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $239.88 |
Where Nevada sits
The same service costs 5.3 times more in Alaska 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
AK $5,518MT $1,050
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.