How much rates vary
Facilitymedian $1,950 · 10th to 90th $537 to $5,129Professionalmedian $219 · 10th to 90th $155 to $398
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 $3,981.07 Typical High $8,128.31 | Facility | None | $190.55 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $281.84 | Professional | None | $186.21 | $186.21 | $281.84 |
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 $199.53 Median $239.88 Typical High $426.58 | Professional | None | $199.53 | $239.88 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $1,348.96 | Facility | None | $691.83 | $977.24 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $380.19 | Professional | None | $154.88 | $213.80 | $380.19 |
Hometown Health Setting Professional Modifier None Typical Low $5.01 Median $204.17 Typical High $295.12 | Professional | None | $5.01 | $204.17 | $295.12 |
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 $4.37 Median $4.37 Typical High $257.04 | Professional | None | $4.37 | $4.37 | $257.04 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $4,265.80 | Facility | None | $169.82 | $169.82 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $467.74 Median $724.44 Typical High $2,884.03 | Facility | None | $467.74 | $724.44 | $2,884.03 |
United Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $416.87 | Professional | None | $190.55 | $234.42 | $416.87 |
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 $93.33 Median $93.33 Typical High $95.50 | Professional | 52 · Reduced service | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 53 · Discontinued | $37.15 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $19.05 |
Where Nevada sits
The same service costs 7.6 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 $4,681MT $618
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.