How much rates vary
Facilitymedian $1,549 · 10th to 90th $302 to $4,365Professionalmedian $170 · 10th to 90th $63 to $347
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 $79.43 Median $1,698.24 Typical High $4,365.16 | Facility | None | $79.43 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $302.00 | Professional | None | $79.43 | $190.55 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $213.80 Typical High $398.11 | Professional | None | $74.13 | $213.80 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $912.01 | Facility | None | $275.42 | $338.84 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $295.12 | Professional | None | $50.12 | $91.20 | $295.12 |
Hometown Health Setting Professional Modifier None Typical Low $61.66 Median $190.55 Typical High $371.54 | Professional | None | $61.66 | $190.55 | $371.54 |
Hometown Health Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Hometown Health Setting Professional Modifier None Typical Low $0.66 Median $104.71 Typical High $457.09 | Professional | None | $0.66 | $104.71 | $457.09 |
Select Health Setting Facility Modifier None Typical Low $70.79 Median $309.03 Typical High $4,265.80 | Facility | None | $70.79 | $309.03 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $309.03 | Professional | None | $58.88 | $87.10 | $309.03 |
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 $47.86 Median $177.83 Typical High $338.84 | Professional | None | $47.86 | $177.83 | $338.84 |
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 $39.81 Median $79.43 Typical High $151.36 | Professional | 52 · Reduced service | $39.81 | $79.43 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $31.62 Typical High $60.26 | Professional | 53 · Discontinued | $15.85 | $31.62 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $120.23 Typical High $229.09 | Professional | 54 · Surgery only | $60.26 | $120.23 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $23.99 Typical High $45.71 | Professional | 55 · Aftercare only | $12.02 | $23.99 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $15.85 Typical High $30.20 | Professional | 56 · Pre-op care only | $7.94 | $15.85 | $30.20 |
Where Nevada sits
The same service costs 9.0 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 $4,579MT $507
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.