How much rates vary
Facilitymedian $1,549 · 10th to 90th $468 to $4,266Professionalmedian $263 · 10th to 90th $155 to $550
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 $467.74 Median $1,698.24 Typical High $4,365.16 | Facility | None | $467.74 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $338.84 Typical High $512.86 | Professional | None | $177.83 | $338.84 | $512.86 |
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 $181.97 Median $208.93 Typical High $346.74 | Professional | None | $181.97 | $208.93 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $1,122.02 | Facility | None | $398.11 | $776.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $575.44 | Professional | None | $154.88 | $281.84 | $575.44 |
Hometown Health Setting Professional Modifier None Typical Low $128.82 Median $275.42 Typical High $851.14 | Professional | None | $128.82 | $275.42 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $2.34 Median $269.15 Typical High $1,174.90 | Professional | None | $2.34 | $269.15 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $181.97 Median $512.86 Typical High $4,265.80 | Facility | None | $181.97 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $489.78 | Professional | None | $144.54 | $338.84 | $489.78 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $154.88 Median $346.74 Typical High $602.56 | Professional | None | $154.88 | $346.74 | $602.56 |
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 $89.13 Median $128.82 Typical High $234.42 | Professional | 52 · Reduced service | $89.13 | $128.82 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $51.29 Typical High $93.33 | Professional | 53 · Discontinued | $35.48 | $51.29 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $190.55 Typical High $354.81 | Professional | 54 · Surgery only | $134.90 | $190.55 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.02 Typical High $70.79 | Professional | 55 · Aftercare only | $26.92 | $38.02 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.70 Typical High $46.77 | Professional | 56 · Pre-op care only | $17.78 | $25.70 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $177.83 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $125.89 | $177.83 | $331.13 |
Where Nevada sits
The same service costs 5.3 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 $4,696MT $888
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.