How much rates vary
Facilitymedian $2,138 · 10th to 90th $871 to $4,467Professionalmedian $759 · 10th to 90th $550 to $1,148
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 $794.33 Median $2,570.40 Typical High $5,011.87 | Facility | None | $794.33 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | None | $660.69 | $794.33 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,047.13 | Professional | None | $630.96 | $724.44 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,659.59 | Facility | None | $616.60 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $1,202.26 | Professional | None | $467.74 | $794.33 | $1,202.26 |
Hometown Health Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,318.26 | Professional | None | $724.44 | $851.14 | $1,318.26 |
Hometown Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $831.76 Typical High $1,698.24 | Professional | None | $10.47 | $831.76 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $776.25 Typical High $4,265.80 | Facility | None | $549.54 | $776.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,174.90 | Professional | None | $512.86 | $776.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,148.15 | Professional | None | $512.86 | $741.31 | $1,148.15 |
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 $331.13 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $131.83 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $66.07 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $660.69 |
Where Nevada sits
The same service costs 3.7 times more in Alaska than in West Virginia. 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 $6,098WV $1,627
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.