How much rates vary
Facilitymedian $1,995 · 10th to 90th $676 to $5,129Professionalmedian $468 · 10th to 90th $331 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 $416.87 Median $2,238.72 Typical High $5,011.87 | Facility | None | $416.87 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $562.34 | Professional | None | $380.19 | $501.19 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $724.44 | Professional | None | $389.05 | $446.68 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,318.26 Typical High $1,905.46 | Facility | None | $501.19 | $1,318.26 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $758.58 | Professional | None | $331.13 | $446.68 | $758.58 |
Hometown Health Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $1,023.29 | Professional | None | $269.15 | $478.63 | $1,023.29 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $3.31 Median $549.54 Typical High $1,949.84 | Professional | None | $3.31 | $549.54 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $537.03 Typical High $4,265.80 | Facility | None | $363.08 | $537.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $741.31 | Professional | None | $295.12 | $457.09 | $741.31 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $794.33 | Professional | None | $302.00 | $478.63 | $794.33 |
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 $190.55 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $190.55 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $75.86 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $281.84 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $57.54 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $38.02 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $389.05 |
Where Nevada sits
The same service costs 4.7 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 $6,464MT $1,390
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.