How much rates vary
Facilitymedian $10,965 · 10th to 90th $1,122 to $36,308Professionalmedian $324 · 10th to 90th $214 to $513
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 $323.59 Median $1,698.24 Typical High $10,715.19 | Facility | None | $323.59 | $1,698.24 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | None | $316.23 | $323.59 | $323.59 |
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 $316.23 Median $363.08 Typical High $575.44 | Professional | None | $316.23 | $363.08 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $14,125.38 Typical High $20,417.38 | Facility | None | $398.11 | $14,125.38 | $20,417.38 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $467.74 | Professional | None | $213.80 | $257.04 | $467.74 |
Hometown Health Setting Professional Modifier None Typical Low $5.50 Median $275.42 Typical High $524.81 | Professional | None | $5.50 | $275.42 | $524.81 |
Hometown Health Setting Facility Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Facility | None | $14,125.38 | $14,125.38 | $14,125.38 |
Hometown Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $467.74 | Professional | None | $4.07 | $4.07 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $4,265.80 | Facility | None | $309.03 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $501.19 | Professional | None | $245.47 | $309.03 | $501.19 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $5,128.61 Typical High $14,791.08 | Facility | None | $2,570.40 | $5,128.61 | $14,791.08 |
United Setting Professional Modifier None Typical Low $104.71 Median $309.03 Typical High $478.63 | Professional | None | $104.71 | $309.03 | $478.63 |
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 $158.49 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $158.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $46.77 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $218.78 | $223.87 | $223.87 |
Where Nevada sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.