How much rates vary
Facilitymedian $1,698 · 10th to 90th $575 to $4,571Professionalmedian $282 · 10th to 90th $209 to $457
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 $218.78 Median $1,698.24 Typical High $4,365.16 | Facility | None | $218.78 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $316.23 | Professional | None | $218.78 | $288.40 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $4,466.84 Typical High $5,754.40 | Facility | None | $2,754.23 | $4,466.84 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $457.09 | Professional | None | $208.93 | $295.12 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $1,862.09 | Facility | None | $398.11 | $1,318.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $416.87 | Professional | None | $177.83 | $223.87 | $416.87 |
Hometown Health Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $1,548.82 | Professional | None | $194.98 | $281.84 | $1,548.82 |
Hometown Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Hometown Health Setting Professional Modifier None Typical Low $0.83 Median $288.40 Typical High $1,949.84 | Professional | None | $0.83 | $288.40 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $4,265.80 | Facility | None | $194.98 | $281.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $194.98 Median $281.84 Typical High $436.52 | Professional | None | $194.98 | $281.84 | $436.52 |
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 $109.65 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $109.65 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $43.65 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $165.96 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $33.11 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $21.88 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $199.53 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $154.88 | $199.53 | $199.53 |
Where Nevada sits
The same service costs 8.6 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 $6,252MT $728
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.