How much rates vary
Facilitymedian $1,514 · 10th to 90th $355 to $4,365Professionalmedian $120 · 10th to 90th $105 to $195
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 $107.15 Median $1,698.24 Typical High $4,466.84 | Facility | None | $107.15 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | None | $107.15 | $107.15 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $104.71 Median $125.89 Typical High $223.87 | Professional | None | $104.71 | $125.89 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $602.56 | Facility | None | $371.54 | $446.68 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $190.55 | Professional | None | $109.65 | $112.20 | $190.55 |
Hometown Health Setting Professional Modifier None Typical Low $2.09 Median $123.03 Typical High $177.83 | Professional | None | $2.09 | $123.03 | $177.83 |
Hometown Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $154.88 | Professional | None | $1.82 | $1.82 | $154.88 |
Select Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $4,265.80 | Facility | None | $102.33 | $102.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $194.98 | Professional | None | $102.33 | $131.83 | $194.98 |
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 $52.48 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where Nevada sits
The same service costs 8.1 times more in New York 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
NY $2,852MT $352
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.