How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,259 to $9,772Professionalmedian $912 · 10th to 90th $692 to $1,413
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 $933.25 Median $2,570.40 Typical High $6,165.95 | Facility | None | $933.25 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $870.96 Median $1,000.00 Typical High $1,621.81 | Professional | None | $870.96 | $1,000.00 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $5,011.87 Typical High $7,244.36 | Facility | None | $616.60 | $5,011.87 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,348.96 | Professional | None | $660.69 | $707.95 | $1,348.96 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $758.58 Typical High $1,380.38 | Professional | None | $11.48 | $758.58 | $1,380.38 |
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 $8.71 Median $8.71 Typical High $1,230.27 | Professional | None | $8.71 | $8.71 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $4,265.80 | Facility | None | $812.83 | $812.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,659.59 | Professional | None | $645.65 | $812.83 | $1,659.59 |
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 $741.31 Median $891.25 Typical High $1,318.26 | Professional | None | $741.31 | $891.25 | $1,318.26 |
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 $426.58 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $660.69 |
Where Nevada sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.