How much rates vary
Facilitymedian $617 · 10th to 90th $123 to $4,365Professionalmedian $275 · 10th to 90th $204 to $447
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 $251.19 Median $512.86 Typical High $10,715.19 | Facility | None | $251.19 | $512.86 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | None | $251.19 | $275.42 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,548.13 Typical High $4,466.84 | Facility | None | $2,238.72 | $3,548.13 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $478.63 | Professional | None | $263.03 | $302.00 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $245.47 | Facility | None | $134.90 | $154.88 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $416.87 | Professional | None | $208.93 | $223.87 | $416.87 |
Hometown Health Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $478.63 | Professional | None | $177.83 | $288.40 | $478.63 |
Hometown Health Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Hometown Health Setting Professional Modifier None Typical Low $0.72 Median $213.80 Typical High $537.03 | Professional | None | $0.72 | $213.80 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $354.81 Typical High $4,265.80 | Facility | None | $302.00 | $354.81 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $602.56 | Professional | None | $245.47 | $323.59 | $602.56 |
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 $173.78 Median $269.15 Typical High $436.52 | Professional | None | $173.78 | $269.15 | $436.52 |
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 $125.89 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $125.89 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $190.55 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $208.93 |
Where Nevada sits
The same service costs 6.4 times more in Colorado than in Florida. 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 $2,602FL $408
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.