How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,549 to $9,772Professionalmedian $1,122 · 10th to 90th $871 to $1,738
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 $1,148.15 Median $3,981.07 Typical High $10,715.19 | Facility | None | $1,148.15 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,023.29 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $1,096.48 Typical High $1,445.44 | Professional | None | $194.98 | $1,096.48 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $11,220.18 | Facility | None | $4,570.88 | $7,762.47 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,202.26 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,073.80 Typical High $5,754.40 | Facility | None | $831.76 | $4,073.80 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $1,621.81 | Professional | None | $891.25 | $912.01 | $1,621.81 |
Hometown Health Setting Professional Modifier None Typical Low $17.38 Median $954.99 Typical High $1,659.59 | Professional | None | $17.38 | $954.99 | $1,659.59 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $1,445.44 | Professional | None | $13.18 | $13.18 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $4,265.80 | Facility | None | $954.99 | $954.99 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,949.84 | Professional | None | $776.25 | $954.99 | $1,949.84 |
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 $870.96 Median $1,122.02 Typical High $1,659.59 | Professional | None | $870.96 | $1,122.02 | $1,659.59 |
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 $512.86 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 53 · Discontinued | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $794.33 |
Where Nevada sits
The same service costs 4.2 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 $14,362MT $3,396
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.