How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,259 to $9,772Professionalmedian $891 · 10th to 90th $692 to $1,413
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 $1,548.82 Median $3,981.07 Typical High $13,489.63 | Facility | None | $1,548.82 | $3,981.07 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | None | $794.33 | $794.33 | $933.25 |
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 $812.83 Median $933.25 Typical High $1,513.56 | Professional | None | $812.83 | $933.25 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,890.45 Typical High $5,495.41 | Facility | None | $794.33 | $3,890.45 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,412.54 | Professional | None | $691.83 | $794.33 | $1,412.54 |
Hometown Health Setting Professional Modifier None Typical Low $11.22 Median $741.31 Typical High $1,288.25 | Professional | None | $11.22 | $741.31 | $1,288.25 |
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 $8.32 Median $8.32 Typical High $1,122.02 | Professional | None | $8.32 | $8.32 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $4,265.80 | Facility | None | $758.58 | $758.58 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,513.56 | Professional | None | $602.56 | $758.58 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $6,165.95 | Facility | None | $1,698.24 | $2,630.27 | $6,165.95 |
United Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,348.96 | Professional | None | $758.58 | $891.25 | $1,348.96 |
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 $398.11 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $616.60 |
Where Nevada sits
The same service costs 5.9 times more in Colorado 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
CO $14,031WV $2,390
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.