How much rates vary
Facilitymedian $1,622 · 10th to 90th $501 to $4,467Professionalmedian $447 · 10th to 90th $288 to $759
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 $524.81 Median $2,238.72 Typical High $5,011.87 | Facility | None | $524.81 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $588.84 | Professional | None | $316.23 | $512.86 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $331.13 Median $380.19 Typical High $616.60 | Professional | None | $331.13 | $380.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,122.02 | Facility | None | $501.19 | $812.83 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $794.33 | Professional | None | $281.84 | $446.68 | $794.33 |
Hometown Health Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $933.25 | Professional | None | $229.09 | $416.87 | $933.25 |
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 $2.14 Median $478.63 Typical High $1,174.90 | Professional | None | $2.14 | $478.63 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $588.84 Typical High $4,265.80 | Facility | None | $316.23 | $588.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $630.96 | Professional | None | $251.19 | $467.74 | $630.96 |
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 $263.03 Median $501.19 Typical High $831.76 | Professional | None | $263.03 | $501.19 | $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 $158.49 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $158.49 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $63.10 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $354.81 Typical High $407.38 | Professional | 54 · Surgery only | $239.88 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $47.86 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $31.62 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $331.13 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $223.87 | $331.13 | $380.19 |
Where Nevada sits
The same service costs 4.4 times more in Colorado than in West Virginia. 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 $4,828WV $1,100
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.