How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,259 to $12,023Professionalmedian $776 · 10th to 90th $603 to $1,288
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 $776.25 Median $3,981.07 Typical High $8,128.31 | Facility | None | $776.25 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,047.13 | Professional | None | $707.95 | $707.95 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $588.84 | Professional | None | $295.12 | $295.12 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,000.00 Typical High $12,302.69 | Facility | None | $5,754.40 | $10,000.00 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,513.56 | Professional | None | $741.31 | $891.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,235.94 Typical High $4,466.84 | Facility | None | $831.76 | $3,235.94 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,202.26 | Professional | None | $602.56 | $676.08 | $1,202.26 |
Hometown Health Setting Professional Modifier None Typical Low $12.88 Median $741.31 Typical High $1,148.15 | Professional | None | $12.88 | $741.31 | $1,148.15 |
Hometown Health Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
Hometown Health Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $977.24 | Professional | None | $10.96 | $10.96 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $4,265.80 | Facility | None | $660.69 | $660.69 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $10,715.19 | Facility | None | $1,698.24 | $2,630.27 | $10,715.19 |
United Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,288.25 | Professional | None | $660.69 | $812.83 | $1,288.25 |
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 $346.74 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $537.03 |
Where Nevada sits
The same service costs 4.5 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 $10,099MT $2,245
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.