How much rates vary
Facilitymedian $2,818 · 10th to 90th $575 to $5,623Professionalmedian $437 · 10th to 90th $339 to $759
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 $436.52 Median $1,698.24 Typical High $4,365.16 | Facility | None | $436.52 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $537.03 | Professional | None | $354.81 | $436.52 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $4,677.35 Typical High $6,165.95 | Facility | None | $2,951.21 | $4,677.35 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $758.58 | Professional | None | $338.84 | $478.63 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $2,818.38 Typical High $4,073.80 | Facility | None | $398.11 | $2,818.38 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $660.69 | Professional | None | $302.00 | $363.08 | $660.69 |
Hometown Health Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $3,388.44 | Professional | None | $316.23 | $457.09 | $3,388.44 |
Hometown Health Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Hometown Health Setting Professional Modifier None Typical Low $1.51 Median $457.09 Typical High $4,265.80 | Professional | None | $1.51 | $457.09 | $4,265.80 |
Select Health Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $4,265.80 | Facility | None | $302.00 | $436.52 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $724.44 | Professional | None | $323.59 | $446.68 | $724.44 |
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 $177.83 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $70.79 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $53.70 |
Where Nevada sits
The same service costs 6.3 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 $7,350MT $1,166
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.