How much rates vary
Facilitymedian $1,047 · 10th to 90th $141 to $3,981Professionalmedian $347 · 10th to 90th $263 to $501
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 $331.13 Median $1,698.24 Typical High $4,365.16 | Facility | None | $331.13 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $398.11 | Professional | None | $323.59 | $331.13 | $398.11 |
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 $309.03 Median $354.81 Typical High $489.78 | Professional | None | $309.03 | $354.81 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $199.53 Typical High $309.03 | Facility | None | $173.78 | $199.53 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $588.84 | Professional | None | $263.03 | $363.08 | $588.84 |
Hometown Health Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $501.19 | Professional | None | $302.00 | $354.81 | $501.19 |
Hometown Health Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Hometown Health Setting Professional Modifier None Typical Low $1.02 Median $275.42 Typical High $501.19 | Professional | None | $1.02 | $275.42 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $331.13 Typical High $4,265.80 | Facility | None | $288.40 | $331.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $524.81 | Professional | None | $269.15 | $363.08 | $524.81 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $524.81 | Professional | None | $173.78 | $323.59 | $524.81 |
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 $162.18 Median $165.96 Typical High $199.53 | Professional | 52 · Reduced service | $162.18 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $79.43 | Professional | 53 · Discontinued | $64.57 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $39.81 | Professional | 56 · Pre-op care only | $32.36 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $275.42 |
Where Nevada sits
The same service costs 7.4 times more in Hawaii than in Florida. 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
HI $3,255FL $440
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.