How much rates vary
Facilitymedian $2,291 · 10th to 90th $832 to $5,495Professionalmedian $457 · 10th to 90th $316 to $724
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 $380.19 Median $2,570.40 Typical High $5,011.87 | Facility | None | $380.19 | $2,570.40 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $575.44 | Professional | None | $346.74 | $512.86 | $575.44 |
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 $354.81 Median $407.38 Typical High $660.69 | Professional | None | $354.81 | $407.38 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,819.70 Typical High $2,511.89 | Facility | None | $616.60 | $1,819.70 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $707.95 | Professional | None | $309.03 | $467.74 | $707.95 |
Hometown Health Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $1,071.52 | Professional | None | $251.19 | $457.09 | $1,071.52 |
Hometown Health Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Hometown Health Setting Professional Modifier None Typical Low $2.75 Median $512.86 Typical High $2,570.40 | Professional | None | $2.75 | $512.86 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $562.34 Typical High $4,265.80 | Facility | None | $346.74 | $562.34 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $630.96 | Professional | None | $275.42 | $446.68 | $630.96 |
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 $309.03 Median $489.78 Typical High $776.25 | Professional | None | $309.03 | $489.78 | $776.25 |
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 $173.78 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $173.78 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $69.18 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $257.04 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $51.29 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $34.67 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $239.88 | $338.84 | $398.11 |
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 $6,438MT $1,383
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.