How much rates vary
Facilitymedian $1,622 · 10th to 90th $537 to $4,467Professionalmedian $263 · 10th to 90th $214 to $380
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 $263.03 Median $2,238.72 Typical High $5,128.61 | Facility | None | $263.03 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | None | $263.03 | $263.03 | $316.23 |
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 $245.47 Median $281.84 Typical High $457.09 | Professional | None | $245.47 | $281.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $758.58 Typical High $1,174.90 | Facility | None | $645.65 | $758.58 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $426.58 | Professional | None | $234.42 | $281.84 | $426.58 |
Hometown Health Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $331.13 | Professional | None | $208.93 | $257.04 | $331.13 |
Hometown Health Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $4,265.80 | Facility | None | $213.80 | $213.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $562.34 | Professional | None | $154.88 | $199.53 | $562.34 |
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 $213.80 Median $257.04 Typical High $363.08 | Professional | None | $213.80 | $257.04 | $363.08 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where Nevada sits
The same service costs 5.6 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 $4,320MT $769
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.