How much rates vary
Facilitymedian $1,738 · 10th to 90th $501 to $4,467Professionalmedian $339 · 10th to 90th $245 to $537
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 $338.84 Median $2,238.72 Typical High $5,128.61 | Facility | None | $338.84 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | None | $309.03 | $309.03 | $338.84 |
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 $316.23 Median $363.08 Typical High $588.84 | Professional | None | $316.23 | $363.08 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,318.26 | Facility | None | $501.19 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $537.03 | Professional | None | $257.04 | $371.54 | $537.03 |
Hometown Health Setting Professional Modifier None Typical Low $4.90 Median $275.42 Typical High $524.81 | Professional | None | $4.90 | $275.42 | $524.81 |
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 $3.63 Median $3.63 Typical High $467.74 | Professional | None | $3.63 | $3.63 | $467.74 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $4,265.80 | Facility | None | $309.03 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $616.60 | Professional | None | $245.47 | $309.03 | $616.60 |
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 $245.47 Median $316.23 Typical High $512.86 | Professional | None | $245.47 | $316.23 | $512.86 |
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 $154.88 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $61.66 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | 54 · Surgery only | $234.42 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $239.88 |
Where Nevada sits
The same service costs 4.6 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 $4,822MT $1,050
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.