How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,096 to $9,333Professionalmedian $457 · 10th to 90th $347 to $708
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 $457.09 Median $2,570.40 Typical High $6,165.95 | Facility | None | $457.09 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | None | $416.87 | $416.87 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $776.25 | Professional | None | $416.87 | $478.63 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,890.45 Typical High $5,495.41 | Facility | None | $616.60 | $3,890.45 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $724.44 | Professional | None | $346.74 | $354.81 | $724.44 |
Hometown Health Setting Professional Modifier None Typical Low $12.59 Median $380.19 Typical High $707.95 | Professional | None | $12.59 | $380.19 | $707.95 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $616.60 | Professional | None | $9.33 | $9.33 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $4,265.80 | Facility | None | $416.87 | $416.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $831.76 | Professional | None | $331.13 | $416.87 | $831.76 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $660.69 | Professional | None | $363.08 | $446.68 | $660.69 |
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 $204.17 Median $204.17 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $309.03 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $316.23 |
Where Nevada sits
The same service costs 8.5 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 $11,809MT $1,385
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.