How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,445 to $40,738Professionalmedian $550 · 10th to 90th $457 to $912
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 $537.03 Median $2,238.72 Typical High $5,128.61 | Facility | None | $537.03 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $912.01 | Professional | None | $524.81 | $537.03 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $22,908.68 Typical High $45,708.82 | Facility | None | $10,964.78 | $22,908.68 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,122.02 | Professional | None | $524.81 | $630.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $29,512.09 Typical High $41,686.94 | Facility | None | $537.03 | $29,512.09 | $41,686.94 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $870.96 | Professional | None | $457.09 | $457.09 | $870.96 |
Hometown Health Setting Professional Modifier None Typical Low $2.57 Median $549.54 Typical High $912.01 | Professional | None | $2.57 | $549.54 | $912.01 |
Hometown Health Setting Facility Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $29,512.09 | Facility | None | $29,512.09 | $29,512.09 | $29,512.09 |
Hometown Health Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $812.83 | Professional | None | $2.24 | $2.24 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $4,265.80 | Facility | None | $549.54 | $549.54 | $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 $3,388.44 Median $9,332.54 Typical High $26,915.35 | Facility | None | $3,388.44 | $9,332.54 | $26,915.35 |
United Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $851.14 | Professional | None | $323.59 | $549.54 | $851.14 |
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 $263.03 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $371.54 | $380.19 | $380.19 |
Where Nevada sits
The same service costs 24.6 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 $43,875MT $1,787
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.