How much rates vary
Facilitymedian $1,380 · 10th to 90th $525 to $4,365Professionalmedian $295 · 10th to 90th $186 to $646
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 $537.03 Median $2,238.72 Typical High $5,011.87 | Facility | None | $537.03 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $537.03 | Professional | None | $204.17 | $295.12 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | None | $177.83 | $177.83 | $186.21 |
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 $190.55 Median $436.52 Typical High $724.44 | Professional | None | $190.55 | $436.52 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $977.24 Typical High $1,412.54 | Facility | None | $537.03 | $977.24 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $562.34 | Professional | None | $186.21 | $190.55 | $562.34 |
Hometown Health Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $1,023.29 | Professional | None | $173.78 | $239.88 | $1,023.29 |
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 $3.24 Median $257.04 Typical High $1,412.54 | Professional | None | $3.24 | $257.04 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $549.54 Typical High $4,265.80 | Facility | None | $169.82 | $549.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $549.54 | Professional | None | $144.54 | $218.78 | $549.54 |
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 $194.98 Median $309.03 Typical High $645.65 | Professional | None | $194.98 | $309.03 | $645.65 |
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 $102.33 Median $147.91 Typical High $269.15 | Professional | 52 · Reduced service | $102.33 | $147.91 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $107.15 | Professional | 53 · Discontinued | $40.74 | $58.88 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $218.78 Typical High $398.11 | Professional | 54 · Surgery only | $151.36 | $218.78 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $44.67 Typical High $79.43 | Professional | 55 · Aftercare only | $30.90 | $44.67 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $29.51 Typical High $53.70 | Professional | 56 · Pre-op care only | $20.42 | $29.51 | $53.70 |
Where Nevada sits
The same service costs 4.1 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 $4,142MT $1,002
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.