How much rates vary
Facilitymedian $1,995 · 10th to 90th $676 to $5,129Professionalmedian $229 · 10th to 90th $158 to $389
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 $173.78 Median $2,238.72 Typical High $5,011.87 | Facility | None | $173.78 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $346.74 | Professional | None | $158.49 | $204.17 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $398.11 | Professional | None | $173.78 | $263.03 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $1,905.46 | Facility | None | $501.19 | $1,318.26 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $323.59 | Professional | None | $151.36 | $204.17 | $323.59 |
Hometown Health Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $1,445.44 | Professional | None | $190.55 | $281.84 | $1,445.44 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $2.04 Median $257.04 Typical High $1,949.84 | Professional | None | $2.04 | $257.04 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $288.40 Typical High $4,265.80 | Facility | None | $173.78 | $288.40 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $147.91 Median $218.78 Typical High $371.54 | Professional | None | $147.91 | $218.78 | $371.54 |
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 $83.18 Median $95.50 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.02 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $144.54 Typical High $190.55 | Professional | 54 · Surgery only | $123.03 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $38.90 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.05 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $134.90 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $114.82 | $134.90 | $177.83 |
Where Nevada sits
The same service costs 9.3 times more in Colorado 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
CO $5,912MT $637
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.