How much rates vary
Facilitymedian $1,549 · 10th to 90th $537 to $4,365Professionalmedian $195 · 10th to 90th $68 to $741
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 $72.44 Median $1,698.24 Typical High $4,365.16 | Facility | None | $72.44 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $489.78 Typical High $645.65 | Professional | None | $72.44 | $489.78 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $67.61 Median $467.74 Typical High $870.96 | Professional | None | $67.61 | $467.74 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,412.54 | Facility | None | $691.83 | $1,023.29 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $676.08 | Professional | None | $60.26 | $95.50 | $676.08 |
Hometown Health Setting Professional Modifier None Typical Low $56.23 Median $446.68 Typical High $891.25 | Professional | None | $56.23 | $446.68 | $891.25 |
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 $2.09 Median $89.13 Typical High $1,412.54 | Professional | None | $2.09 | $89.13 | $1,412.54 |
Select Health Setting Facility Modifier None Typical Low $60.26 Median $549.54 Typical High $4,265.80 | Facility | None | $60.26 | $549.54 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $549.54 | Professional | None | $51.29 | $79.43 | $549.54 |
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 $72.44 Median $398.11 Typical High $707.95 | Professional | None | $72.44 | $398.11 | $707.95 |
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 $36.31 Median $213.80 Typical High $323.59 | Professional | 52 · Reduced service | $36.31 | $213.80 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $85.11 Typical High $128.82 | Professional | 53 · Discontinued | $14.45 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $323.59 Typical High $478.63 | Professional | 54 · Surgery only | $53.70 | $323.59 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $64.57 Typical High $95.50 | Professional | 55 · Aftercare only | $10.72 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $42.66 Typical High $64.57 | Professional | 56 · Pre-op care only | $7.24 | $42.66 | $64.57 |
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 $4,728MT $843
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.