How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,349 to $9,772Professionalmedian $794 · 10th to 90th $617 to $1,202
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 $776.25 Median $3,162.28 Typical High $7,244.36 | Facility | None | $776.25 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Professional | None | $707.95 | $707.95 | $776.25 |
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 $724.44 Median $831.76 Typical High $1,348.96 | Professional | None | $724.44 | $831.76 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $5,370.32 Typical High $7,762.47 | Facility | None | $724.44 | $5,370.32 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,258.93 | Professional | None | $616.60 | $660.69 | $1,258.93 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $660.69 Typical High $1,122.02 | Professional | None | $10.00 | $660.69 | $1,122.02 |
Hometown Health Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
Hometown Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $1,000.00 | Professional | None | $7.59 | $7.59 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $4,265.80 | Facility | None | $660.69 | $660.69 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,348.96 | Professional | None | $524.81 | $660.69 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,174.90 | Professional | None | $645.65 | $794.33 | $1,174.90 |
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 $354.81 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $141.25 | $141.25 | $154.88 |
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 $70.79 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $77.62 |
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 6.2 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 $14,513MT $2,350
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.