How much rates vary
Facilitymedian $1,230 · 10th to 90th $151 to $4,266Professionalmedian $457 · 10th to 90th $339 to $708
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 $457.09 Median $1,698.24 Typical High $4,365.16 | Facility | None | $457.09 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | None | $407.38 | $457.09 | $501.19 |
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 $426.58 Median $489.78 Typical High $758.58 | Professional | None | $426.58 | $489.78 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $1,318.26 | Facility | None | $398.11 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $676.08 | Professional | None | $338.84 | $371.54 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $281.84 Median $467.74 Typical High $891.25 | Professional | None | $281.84 | $467.74 | $891.25 |
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 $2.75 Median $630.96 Typical High $1,380.38 | Professional | None | $2.75 | $630.96 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $4,265.80 | Facility | None | $416.87 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $831.76 | Professional | None | $331.13 | $467.74 | $831.76 |
United Setting Facility Modifier None Typical Low $97.72 Median $245.47 Typical High $1,949.84 | Facility | None | $97.72 | $245.47 | $1,949.84 |
United Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $676.08 | Professional | None | $302.00 | $436.52 | $676.08 |
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 $204.17 Median $223.87 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $316.23 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $316.23 | $331.13 |
Where Nevada sits
The same service costs 5.3 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 $4,377FL $831
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.