How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,122 to $9,333Professionalmedian $977 · 10th to 90th $708 to $1,514
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 $977.24 Median $3,162.28 Typical High $7,244.36 | Facility | None | $977.24 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | None | $891.25 | $891.25 | $977.24 |
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 $933.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $933.25 | $1,071.52 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $3,890.45 Typical High $5,495.41 | Facility | None | $724.44 | $3,890.45 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,412.54 | Professional | None | $741.31 | $794.33 | $1,412.54 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $794.33 Typical High $1,513.56 | Professional | None | $10.00 | $794.33 | $1,513.56 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $1,318.26 | Professional | None | $7.41 | $7.41 | $1,318.26 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $4,265.80 | Facility | None | $891.25 | $891.25 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,778.28 | Professional | None | $707.95 | $891.25 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $4,073.80 | Facility | None | $1,174.90 | $1,698.24 | $4,073.80 |
United Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,412.54 | Professional | None | $575.44 | $933.25 | $1,412.54 |
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 $446.68 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $691.83 |
Where Nevada sits
The same service costs 4.2 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 $12,508MT $2,994
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.