How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $9,772Professionalmedian $776 · 10th to 90th $575 to $1,175
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 $794.33 Median $2,570.40 Typical High $6,165.95 | Facility | None | $794.33 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | None | $724.44 | $724.44 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $741.31 Median $851.14 Typical High $1,348.96 | Professional | None | $741.31 | $851.14 | $1,348.96 |
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 $501.19 Median $630.96 Typical High $1,096.48 | Professional | None | $501.19 | $630.96 | $1,096.48 |
Hometown Health Setting Professional Modifier None Typical Low $10.47 Median $676.08 Typical High $1,174.90 | Professional | None | $10.47 | $676.08 | $1,174.90 |
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 $7.76 Median $7.76 Typical High $1,047.13 | Professional | None | $7.76 | $7.76 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $4,265.80 | Facility | None | $691.83 | $691.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,412.54 | Professional | None | $562.34 | $691.83 | $1,412.54 |
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 $575.44 Median $758.58 Typical High $1,148.15 | Professional | None | $575.44 | $758.58 | $1,148.15 |
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 $363.08 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $549.54 |
Where Nevada sits
The same service costs 5.6 times more in Colorado than in Hawaii. 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 $13,636HI $2,423
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.