How much rates vary
Facilitymedian $2,239 · 10th to 90th $676 to $4,467Professionalmedian $282 · 10th to 90th $219 to $468
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 $245.47 Median $2,238.72 Typical High $5,011.87 | Facility | None | $245.47 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $338.84 | Professional | None | $223.87 | $275.42 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $234.42 Median $331.13 Typical High $501.19 | Professional | None | $234.42 | $331.13 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $2,630.27 | Facility | None | $501.19 | $1,819.70 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $407.38 | Professional | None | $186.21 | $218.78 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $2,187.76 | Professional | None | $208.93 | $309.03 | $2,187.76 |
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 $3.09 Median $309.03 Typical High $2,691.53 | Professional | None | $3.09 | $309.03 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $4,265.80 | Facility | None | $204.17 | $295.12 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $223.87 Median $288.40 Typical High $446.68 | Professional | None | $223.87 | $288.40 | $446.68 |
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 $109.65 Median $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $109.65 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $52.48 Typical High $61.66 | Professional | 53 · Discontinued | $44.67 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $165.96 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $154.88 | $181.97 | $218.78 |
Where Nevada sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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 $5,029WV $590
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.