How much rates vary
Facilitymedian $1,862 · 10th to 90th $501 to $14,791Professionalmedian $191 · 10th to 90th $145 to $309
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 $190.55 Median $2,238.72 Typical High $5,128.61 | Facility | None | $190.55 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | None | $181.97 | $181.97 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $11,481.54 Typical High $18,197.01 | Facility | None | $5,495.41 | $11,481.54 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $380.19 | Professional | None | $169.82 | $204.17 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $1,318.26 | Facility | None | $537.03 | $933.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $281.84 | Professional | None | $144.54 | $162.18 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $1.95 Median $173.78 Typical High $257.04 | Professional | None | $1.95 | $173.78 | $257.04 |
Hometown Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Hometown Health Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $223.87 | Professional | None | $1.70 | $1.70 | $223.87 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $4,265.80 | Facility | None | $151.36 | $151.36 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $3,630.78 | Facility | None | $467.74 | $724.44 | $3,630.78 |
United Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $309.03 | Professional | None | $151.36 | $194.98 | $309.03 |
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 $91.20 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $36.31 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | 54 · Surgery only | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $19.05 |
Where Nevada sits
The same service costs 9.2 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 $4,822MT $526
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.