How much rates vary
Facilitymedian $2,089 · 10th to 90th $759 to $4,571Professionalmedian $219 · 10th to 90th $178 to $355
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 $4,466.84 | Facility | None | $218.78 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $309.03 | Professional | None | $218.78 | $218.78 | $309.03 |
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 $204.17 Median $245.47 Typical High $446.68 | Professional | None | $204.17 | $245.47 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,819.70 Typical High $2,570.40 | Facility | None | $398.11 | $1,819.70 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $338.84 | Professional | None | $177.83 | $186.21 | $338.84 |
Hometown Health Setting Professional Modifier None Typical Low $2.82 Median $213.80 Typical High $331.13 | Professional | None | $2.82 | $213.80 | $331.13 |
Hometown Health Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Hometown Health Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $288.40 | Professional | None | $2.40 | $2.40 | $288.40 |
Select Health Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $4,265.80 | Facility | None | $190.55 | $190.55 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $190.55 Median $223.87 Typical High $346.74 | Professional | None | $190.55 | $223.87 | $346.74 |
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 $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $151.36 |
Where Nevada sits
The same service costs 9.6 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 $6,197MT $647
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.