How much rates vary
Facilitymedian $1,349 · 10th to 90th $457 to $4,074Professionalmedian $186 · 10th to 90th $123 to $479
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 $138.04 Median $1,698.24 Typical High $4,365.16 | Facility | None | $138.04 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $416.87 | Professional | None | $138.04 | $190.55 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $5,128.61 | Facility | None | $1,096.48 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $338.84 Typical High $549.54 | Professional | None | $125.89 | $338.84 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $977.24 Typical High $1,412.54 | Facility | None | $407.38 | $977.24 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $436.52 | Professional | None | $120.23 | $125.89 | $436.52 |
Hometown Health Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $933.25 | Professional | None | $112.20 | $154.88 | $933.25 |
Hometown Health Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Hometown Health Setting Professional Modifier None Typical Low $2.45 Median $173.78 Typical High $1,412.54 | Professional | None | $2.45 | $173.78 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $114.82 Median $416.87 Typical High $4,265.80 | Facility | None | $114.82 | $416.87 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $416.87 | Professional | None | $97.72 | $147.91 | $416.87 |
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 $128.82 Median $204.17 Typical High $489.78 | Professional | None | $128.82 | $204.17 | $489.78 |
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 $67.61 Median $95.50 Typical High $208.93 | Professional | 52 · Reduced service | $67.61 | $95.50 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $83.18 | Professional | 53 · Discontinued | $27.54 | $38.90 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $144.54 Typical High $309.03 | Professional | 54 · Surgery only | $102.33 | $144.54 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.84 Typical High $61.66 | Professional | 55 · Aftercare only | $20.42 | $28.84 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $41.69 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $41.69 |
Where Nevada sits
The same service costs 5.7 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 $4,090MT $722
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.