How much rates vary
Facilitymedian $1,995 · 10th to 90th $676 to $5,129Professionalmedian $380 · 10th to 90th $269 to $617
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 $281.84 Median $2,238.72 Typical High $5,011.87 | Facility | None | $281.84 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $501.19 | Professional | None | $263.03 | $346.74 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $288.40 Median $416.87 Typical High $602.56 | Professional | None | $288.40 | $416.87 | $602.56 |
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 $245.47 Median $338.84 Typical High $512.86 | Professional | None | $245.47 | $338.84 | $512.86 |
Hometown Health Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $1,445.44 | Professional | None | $275.42 | $457.09 | $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 $3.39 Median $371.54 Typical High $1,949.84 | Professional | None | $3.39 | $371.54 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $4,265.80 | Facility | None | $251.19 | $416.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $275.42 Median $371.54 Typical High $616.60 | Professional | None | $275.42 | $371.54 | $616.60 |
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 $134.90 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $134.90 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $64.57 Typical High $79.43 | Professional | 53 · Discontinued | $53.70 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $204.17 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $40.74 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $32.36 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $190.55 | $229.09 | $275.42 |
Where Nevada sits
The same service costs 6.1 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 $6,346MT $1,043
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.