How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,122 to $9,333Professionalmedian $525 · 10th to 90th $347 to $813
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 $537.03 Median $3,162.28 Typical High $7,244.36 | Facility | None | $537.03 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | None | $489.78 | $489.78 | $537.03 |
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 $501.19 Median $575.44 Typical High $933.25 | Professional | None | $501.19 | $575.44 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,890.45 Typical High $5,495.41 | Facility | None | $724.44 | $3,890.45 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $776.25 | Professional | None | $239.88 | $426.58 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $2.09 Median $426.58 Typical High $794.33 | Professional | None | $2.09 | $426.58 | $794.33 |
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 $1.55 Median $1.55 Typical High $691.83 | Professional | None | $1.55 | $1.55 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $4,265.80 | Facility | None | $467.74 | $467.74 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $933.25 | Professional | None | $371.54 | $467.74 | $933.25 |
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 $204.17 Median $512.86 Typical High $776.25 | Professional | None | $204.17 | $512.86 | $776.25 |
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 $245.47 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $371.54 |
Where Nevada sits
The same service costs 7.5 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 $12,189MT $1,626
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.