How much rates vary
Facilitymedian $1,549 · 10th to 90th $525 to $4,467Professionalmedian $525 · 10th to 90th $427 to $832
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 $524.81 Median $2,238.72 Typical High $5,011.87 | Facility | None | $524.81 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | None | $478.63 | $524.81 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $912.01 | Professional | None | $489.78 | $562.34 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,318.26 | Facility | None | $501.19 | $912.01 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $794.33 | Professional | None | $416.87 | $457.09 | $794.33 |
Hometown Health Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $1,000.00 | Professional | None | $338.84 | $562.34 | $1,000.00 |
Hometown Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $4.68 Median $707.95 Typical High $1,380.38 | Professional | None | $4.68 | $707.95 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $4,265.80 | Facility | None | $467.74 | $602.56 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $954.99 | Professional | None | $380.19 | $537.03 | $954.99 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $812.83 | Professional | None | $446.68 | $537.03 | $812.83 |
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 $239.88 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $389.05 |
Where Nevada sits
The same service costs 4.0 times more in Colorado than in Alabama. 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 $5,057AL $1,277
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.