How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,259 to $10,715Professionalmedian $661 · 10th to 90th $513 to $891
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 $676.08 Median $2,570.40 Typical High $6,165.95 | Facility | None | $676.08 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,311.31 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,174.90 | Professional | None | $630.96 | $707.95 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $17,782.79 | Facility | None | $758.58 | $3,467.37 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $851.14 | Professional | None | $467.74 | $537.03 | $851.14 |
Hometown Health Setting Professional Modifier None Typical Low $12.59 Median $588.84 Typical High $851.14 | Professional | None | $12.59 | $588.84 | $851.14 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $891.25 | Professional | None | $9.33 | $9.33 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $4,265.80 | Facility | None | $588.84 | $588.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,202.26 | Professional | None | $398.11 | $537.03 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $6,165.95 | Facility | None | $1,698.24 | $2,630.27 | $6,165.95 |
United Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $831.76 | Professional | None | $524.81 | $630.96 | $831.76 |
6 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 $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
Where Nevada sits
The same service costs 5.4 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 $11,084MT $2,070
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.