How much rates vary
Facilitymedian $2,951 · 10th to 90th $537 to $5,888Professionalmedian $302 · 10th to 90th $251 to $417
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 $302.00 Median $2,238.72 Typical High $5,128.61 | Facility | None | $302.00 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $4,677.35 Typical High $6,165.95 | Facility | None | $1,096.48 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $524.81 | Professional | None | $281.84 | $323.59 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $4,677.35 Typical High $6,760.83 | Facility | None | $741.31 | $4,677.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $416.87 | Professional | None | $269.15 | $288.40 | $416.87 |
Hometown Health Setting Professional Modifier None Typical Low $6.46 Median $269.15 Typical High $371.54 | Professional | None | $6.46 | $269.15 | $371.54 |
Hometown Health Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Hometown Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $371.54 | Professional | None | $4.79 | $4.79 | $371.54 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $4,265.80 | Facility | None | $251.19 | $251.19 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $645.65 | Professional | None | $177.83 | $229.09 | $645.65 |
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 $251.19 Median $295.12 Typical High $407.38 | Professional | None | $251.19 | $295.12 | $407.38 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Where Nevada sits
The same service costs 7.8 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 $7,005MT $893
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.