How much rates vary
Facilitymedian $1,698 · 10th to 90th $501 to $4,467Professionalmedian $155 · 10th to 90th $69 to $269
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 $158.49 Median $1,698.24 Typical High $5,011.87 | Facility | None | $158.49 | $1,698.24 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $208.93 | Professional | None | $67.61 | $158.49 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $165.96 Typical High $288.40 | Professional | None | $74.13 | $165.96 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,445.44 Typical High $1,949.84 | Facility | None | $676.08 | $1,445.44 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $218.78 | Professional | None | $63.10 | $138.04 | $218.78 |
Hometown Health Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $1,548.82 | Professional | None | $69.18 | $158.49 | $1,548.82 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $0.78 Median $93.33 Typical High $1,949.84 | Professional | None | $0.78 | $93.33 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $61.66 Median $177.83 Typical High $4,265.80 | Facility | None | $61.66 | $177.83 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
United Setting Facility Modifier None Typical Low $467.74 Median $776.25 Typical High $2,884.03 | Facility | None | $467.74 | $776.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $77.62 Median $169.82 Typical High $263.03 | Professional | None | $77.62 | $169.82 | $263.03 |
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 $33.88 Median $54.95 Typical High $79.43 | Professional | 52 · Reduced service | $33.88 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $13.49 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $83.18 Typical High $120.23 | Professional | 54 · Surgery only | $51.29 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.60 Typical High $23.99 | Professional | 55 · Aftercare only | $10.23 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.76 | $10.96 | $15.85 |
Where Nevada sits
The same service costs 9.7 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 $4,351MT $447
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.