How much rates vary
Facilitymedian $1,318 · 10th to 90th $151 to $4,266Professionalmedian $347 · 10th to 90th $234 to $562
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 $371.54 Median $1,698.24 Typical High $4,466.84 | Facility | None | $371.54 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | None | $338.84 | $338.84 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $346.74 Median $407.38 Typical High $645.65 | Professional | None | $346.74 | $407.38 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $954.99 Typical High $1,348.96 | Facility | None | $426.58 | $954.99 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $489.78 | Professional | None | $234.42 | $275.42 | $489.78 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $323.59 Typical High $575.44 | Professional | None | $3.63 | $323.59 | $575.44 |
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 $2.69 Median $2.69 Typical High $549.54 | Professional | None | $2.69 | $2.69 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $4,265.80 | Facility | None | $363.08 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $724.44 | Professional | None | $288.40 | $363.08 | $724.44 |
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 $218.78 Median $338.84 Typical High $512.86 | Professional | None | $218.78 | $338.84 | $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 $169.82 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $67.61 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $251.19 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $257.04 |
Where Nevada sits
The same service costs 5.9 times more in Colorado than in Kentucky. 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 $4,303KY $729
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.