How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,380 to $9,772Professionalmedian $575 · 10th to 90th $457 to $933
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 $575.44 Median $2,570.40 Typical High $6,165.95 | Facility | None | $575.44 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | None | $524.81 | $524.81 | $575.44 |
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 $537.03 Median $616.60 Typical High $1,000.00 | Professional | None | $537.03 | $616.60 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $4,073.80 Typical High $5,754.40 | Facility | None | $616.60 | $4,073.80 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $912.01 | Professional | None | $457.09 | $549.54 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $8.71 Median $489.78 Typical High $870.96 | Professional | None | $8.71 | $489.78 | $870.96 |
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 $6.46 Median $6.46 Typical High $758.58 | Professional | None | $6.46 | $6.46 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $4,265.80 | Facility | None | $512.86 | $512.86 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $1,023.29 | Professional | None | $407.38 | $512.86 | $1,023.29 |
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 $467.74 Median $549.54 Typical High $977.24 | Professional | None | $467.74 | $549.54 | $977.24 |
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 $263.03 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $407.38 |
Where Nevada sits
The same service costs 7.9 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 $13,941MT $1,762
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.