How much rates vary
Facilitymedian $1,622 · 10th to 90th $457 to $4,365Professionalmedian $195 · 10th to 90th $129 to $309
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 $134.90 Median $1,698.24 Typical High $4,365.16 | Facility | None | $134.90 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $213.80 | Professional | None | $134.90 | $199.53 | $213.80 |
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 $128.82 Median $194.98 Typical High $323.59 | Professional | None | $128.82 | $194.98 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,174.90 Typical High $1,698.24 | Facility | None | $398.11 | $1,174.90 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $281.84 | Professional | None | $109.65 | $154.88 | $281.84 |
Hometown Health Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $1,412.54 | Professional | None | $120.23 | $194.98 | $1,412.54 |
Hometown Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Hometown Health Setting Professional Modifier None Typical Low $1.20 Median $181.97 Typical High $1,778.28 | Professional | None | $1.20 | $181.97 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $120.23 Median $199.53 Typical High $4,265.80 | Facility | None | $120.23 | $199.53 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $117.49 Median $186.21 Typical High $295.12 | Professional | None | $117.49 | $186.21 | $295.12 |
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 $67.61 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $67.61 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $40.74 | Professional | 53 · Discontinued | $27.54 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $147.91 Typical High $154.88 | Professional | 54 · Surgery only | $102.33 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.49 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $138.04 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $95.50 | $138.04 | $144.54 |
Where Nevada sits
The same service costs 9.9 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 $4,605MT $466
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.