How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,259 to $10,233Professionalmedian $955 · 10th to 90th $724 to $1,445
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 $1,096.48 Median $3,162.28 Typical High $7,244.36 | Facility | None | $1,096.48 | $3,162.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | None | $891.25 | $891.25 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $11,220.18 | Facility | None | $4,897.79 | $8,128.31 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,862.09 | Professional | None | $851.14 | $1,023.29 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $5,248.07 Typical High $7,585.78 | Facility | None | $691.83 | $5,248.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,412.54 | Professional | None | $724.44 | $812.83 | $1,412.54 |
Hometown Health Setting Professional Modifier None Typical Low $14.13 Median $758.58 Typical High $1,096.48 | Professional | None | $14.13 | $758.58 | $1,096.48 |
Hometown Health Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Hometown Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $933.25 | Professional | None | $12.02 | $12.02 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $4,265.80 | Facility | None | $616.60 | $616.60 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,621.81 | $2,398.83 | $6,165.95 |
United Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,445.44 | Professional | None | $676.08 | $977.24 | $1,445.44 |
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 $446.68 Median $446.68 Typical High $549.54 | Professional | 52 · Reduced service | $446.68 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $758.58 |
Where Nevada sits
The same service costs 6.6 times more in Colorado than in Kentucky. 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 $14,612KY $2,222
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.