How much rates vary
Facilitymedian $2,239 · 10th to 90th $891 to $5,012Professionalmedian $195 · 10th to 90th $155 to $324
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 $186.21 Median $2,238.72 Typical High $5,128.61 | Facility | None | $186.21 | $2,238.72 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $257.04 | Professional | None | $169.82 | $169.82 | $257.04 |
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 $177.83 Median $213.80 Typical High $389.05 | Professional | None | $177.83 | $213.80 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $2,630.27 | Facility | None | $501.19 | $1,819.70 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $302.00 | Professional | None | $154.88 | $186.21 | $302.00 |
Hometown Health Setting Professional Modifier None Typical Low $3.63 Median $186.21 Typical High $281.84 | Professional | None | $3.63 | $186.21 | $281.84 |
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 $3.09 Median $3.09 Typical High $239.88 | Professional | None | $3.09 | $3.09 | $239.88 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $4,265.80 | Facility | None | $162.18 | $162.18 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $162.18 Median $208.93 Typical High $323.59 | Professional | None | $162.18 | $208.93 | $323.59 |
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 $85.11 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 53 · Discontinued | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $131.83 |
Where Nevada sits
The same service costs 8.1 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 $4,634MT $570
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.