How much rates vary
Facilitymedian $1,413 · 10th to 90th $501 to $4,365Professionalmedian $191 · 10th to 90th $158 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 $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $177.83 Median $199.53 Typical High $323.59 | Professional | None | $177.83 | $199.53 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $933.25 Typical High $1,348.96 | Facility | None | $501.19 | $933.25 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $275.42 | Professional | None | $165.96 | $177.83 | $275.42 |
Hometown Health Setting Professional Modifier None Typical Low $4.47 Median $177.83 Typical High $251.19 | Professional | None | $4.47 | $177.83 | $251.19 |
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 $3.39 Median $3.39 Typical High $239.88 | Professional | None | $3.39 | $3.39 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $4,265.80 | Facility | None | $158.49 | $158.49 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $331.13 | Professional | None | $112.20 | $144.54 | $331.13 |
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 $158.49 Median $190.55 Typical High $309.03 | Professional | None | $158.49 | $190.55 | $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 $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $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 $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Where Nevada sits
The same service costs 7.3 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 $4,136MT $564
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.