How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,259 to $9,772Professionalmedian $794 · 10th to 90th $631 to $1,230
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 $812.83 Median $2,570.40 Typical High $6,165.95 | Facility | None | $812.83 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $812.83 | Professional | None | $741.31 | $741.31 | $812.83 |
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 $758.58 Median $870.96 Typical High $1,380.38 | Professional | None | $758.58 | $870.96 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $5,128.61 Typical High $7,244.36 | Facility | None | $616.60 | $5,128.61 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $676.08 Typical High $1,230.27 | Professional | None | $630.96 | $676.08 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $660.69 Typical High $1,148.15 | Professional | None | $12.02 | $660.69 | $1,148.15 |
Hometown Health Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Hometown Health Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $1,000.00 | Professional | None | $9.12 | $9.12 | $1,000.00 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $4,265.80 | Facility | None | $660.69 | $660.69 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,348.96 | Professional | None | $537.03 | $660.69 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,202.26 | Professional | None | $660.69 | $776.25 | $1,202.26 |
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 $371.54 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $371.54 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $549.54 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $562.34 |
Where Nevada sits
The same service costs 6.0 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 $14,230MT $2,377
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.