How much rates vary
Facilitymedian $1,514 · 10th to 90th $407 to $4,786Professionalmedian $562 · 10th to 90th $417 to $871
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 $549.54 Median $2,570.40 Typical High $5,011.87 | Facility | None | $549.54 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $660.69 | Professional | None | $501.19 | $524.81 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $954.99 | Professional | None | $512.86 | $588.84 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $954.99 Typical High $1,318.26 | Facility | None | $616.60 | $954.99 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $831.76 | Professional | None | $416.87 | $467.74 | $831.76 |
Hometown Health Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $1,000.00 | Professional | None | $354.81 | $602.56 | $1,000.00 |
Hometown Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $2.69 Median $812.83 Typical High $1,380.38 | Professional | None | $2.69 | $812.83 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $630.96 Typical High $4,265.80 | Facility | None | $537.03 | $630.96 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $1,096.48 | Professional | None | $436.52 | $562.34 | $1,096.48 |
United Setting Facility Modifier None Typical Low $302.00 Median $512.86 Typical High $2,137.96 | Facility | None | $302.00 | $512.86 | $2,137.96 |
United Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $831.76 | Professional | None | $389.05 | $562.34 | $831.76 |
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 $251.19 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $100.00 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $407.38 |
Where Nevada sits
The same service costs 4.0 times more in Colorado than in Florida. 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 $4,440FL $1,118
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.