How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,349 to $9,772Professionalmedian $562 · 10th to 90th $398 to $891
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 $588.84 Median $3,162.28 Typical High $7,244.36 | Facility | None | $588.84 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $676.08 | Professional | None | $537.03 | $537.03 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | None | $512.86 | $512.86 | $616.60 |
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 $549.54 Median $630.96 Typical High $1,023.29 | Professional | None | $549.54 | $630.96 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $5,011.87 Typical High $7,079.46 | Facility | None | $724.44 | $5,011.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $794.33 | Professional | None | $398.11 | $436.52 | $794.33 |
Hometown Health Setting Professional Modifier None Typical Low $4.90 Median $478.63 Typical High $891.25 | Professional | None | $4.90 | $478.63 | $891.25 |
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 $3.63 Median $3.63 Typical High $812.83 | Professional | None | $3.63 | $3.63 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $4,265.80 | Facility | None | $537.03 | $537.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $1,000.00 | Professional | None | $426.58 | $537.03 | $1,000.00 |
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 $389.05 Median $562.34 Typical High $831.76 | Professional | None | $389.05 | $562.34 | $831.76 |
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 $269.15 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $398.11 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $416.87 |
Where Nevada sits
The same service costs 7.5 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 $13,659MT $1,825
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.