How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,259 to $9,772Professionalmedian $603 · 10th to 90th $479 to $955
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 $616.60 Median $2,570.40 Typical High $6,165.95 | Facility | None | $616.60 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | None | $549.54 | $549.54 | $616.60 |
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 $562.34 Median $660.69 Typical High $1,047.13 | Professional | None | $562.34 | $660.69 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $5,128.61 Typical High $7,413.10 | Facility | None | $616.60 | $5,128.61 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $1,000.00 | Professional | None | $478.63 | $489.78 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $10.23 Median $512.86 Typical High $912.01 | Professional | None | $10.23 | $512.86 | $912.01 |
Hometown Health Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $794.33 | Professional | None | $7.59 | $7.59 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $4,265.80 | Facility | None | $537.03 | $537.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $1,071.52 | Professional | None | $426.58 | $537.03 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,090.30 | $6,456.54 |
United Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $891.25 | Professional | None | $501.19 | $602.56 | $891.25 |
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 $275.42 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $426.58 |
Where Nevada sits
The same service costs 7.4 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 $13,677MT $1,845
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.