How much rates vary
Facilitymedian $2,399 · 10th to 90th $832 to $5,495Professionalmedian $398 · 10th to 90th $288 to $646
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 $467.74 Median $2,570.40 Typical High $10,715.19 | Facility | None | $467.74 | $2,570.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $512.86 | Professional | None | $309.03 | $446.68 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $323.59 Median $371.54 Typical High $588.84 | Professional | None | $323.59 | $371.54 | $588.84 |
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 $263.03 Median $398.11 Typical High $645.65 | Professional | None | $263.03 | $398.11 | $645.65 |
Hometown Health Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $954.99 | Professional | None | $218.78 | $416.87 | $954.99 |
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 $3.63 Median $467.74 Typical High $2,570.40 | Professional | None | $3.63 | $467.74 | $2,570.40 |
Select Health Setting Facility Modifier None Typical Low $309.03 Median $501.19 Typical High $4,265.80 | Facility | None | $309.03 | $501.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $575.44 | Professional | None | $245.47 | $398.11 | $575.44 |
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 $426.58 Typical High $660.69 | Professional | None | $309.03 | $426.58 | $660.69 |
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 $154.88 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $154.88 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $61.66 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $234.42 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $46.77 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $218.78 | $309.03 | $346.74 |
Where Nevada sits
The same service costs 6.4 times more in Colorado than in West Virginia. 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 $6,390WV $1,003
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.