How much rates vary
Facilitymedian $2,239 · 10th to 90th $871 to $5,129Professionalmedian $275 · 10th to 90th $214 to $447
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 $275.42 Median $2,238.72 Typical High $5,128.61 | Facility | None | $275.42 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $323.59 | Professional | None | $257.04 | $257.04 | $323.59 |
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 $239.88 Median $295.12 Typical High $537.03 | Professional | None | $239.88 | $295.12 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $2,570.40 | Facility | None | $501.19 | $1,778.28 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $407.38 | Professional | None | $213.80 | $234.42 | $407.38 |
Hometown Health Setting Professional Modifier None Typical Low $4.90 Median $251.19 Typical High $363.08 | Professional | None | $4.90 | $251.19 | $363.08 |
Hometown Health Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Hometown Health Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $309.03 | Professional | None | $4.17 | $4.17 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $4,265.80 | Facility | None | $208.93 | $208.93 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $213.80 Median $275.42 Typical High $478.63 | Professional | None | $213.80 | $275.42 | $478.63 |
5 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 $128.82 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $128.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 53 · Discontinued | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | 54 · Surgery only | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $40.74 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $27.54 |
Where Nevada sits
The same service costs 8.5 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 $6,252MT $735
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.