How much rates vary
Facilitymedian $2,512 · 10th to 90th $933 to $5,129Professionalmedian $617 · 10th to 90th $427 to $1,023
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 $616.60 Median $3,981.07 Typical High $8,128.31 | Facility | None | $616.60 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $891.25 | Professional | None | $537.03 | $549.54 | $891.25 |
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 $588.84 Median $707.95 Typical High $1,096.48 | Professional | None | $588.84 | $707.95 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,905.46 Typical High $2,630.27 | Facility | None | $794.33 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $912.01 | Professional | None | $426.58 | $426.58 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $8.51 Median $537.03 Typical High $912.01 | Professional | None | $8.51 | $537.03 | $912.01 |
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 $7.24 Median $7.24 Typical High $812.83 | Professional | None | $7.24 | $7.24 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $4,265.80 | Facility | None | $537.03 | $537.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,047.13 | Professional | None | $489.78 | $616.60 | $1,047.13 |
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 $275.42 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $426.58 |
Where Nevada sits
The same service costs 3.6 times more in Oklahoma 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
OK $6,446MT $1,806
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.