How much rates vary
Facilitymedian $1,288 · 10th to 90th $331 to $4,266Professionalmedian $145 · 10th to 90th $100 to $229
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 $162.18 Median $1,698.24 Typical High $4,365.16 | Facility | None | $162.18 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $165.96 | Professional | None | $109.65 | $151.36 | $165.96 |
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 $109.65 Median $125.89 Typical High $204.17 | Professional | None | $109.65 | $125.89 | $204.17 |
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 $93.33 Median $144.54 Typical High $234.42 | Professional | None | $93.33 | $144.54 | $234.42 |
Hometown Health Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $323.59 | Professional | None | $77.62 | $138.04 | $323.59 |
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 $0.60 Median $151.36 Typical High $602.56 | Professional | None | $0.60 | $151.36 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $100.00 Median $169.82 Typical High $4,265.80 | Facility | None | $100.00 | $169.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $831.76 | Professional | None | $81.28 | $154.88 | $831.76 |
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 $154.88 Typical High $239.88 | Professional | None | $102.33 | $154.88 | $239.88 |
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 $54.95 Median $72.44 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $21.88 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $109.65 Typical High $125.89 | Professional | 54 · Surgery only | $83.18 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $16.60 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.96 | $14.79 | $16.60 |
Where Nevada sits
The same service costs 6.3 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 $2,712MT $427
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.