How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,698 to $10,715Professionalmedian $933 · 10th to 90th $759 to $1,549
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 $933.25 Median $4,466.84 Typical High $8,128.31 | Facility | None | $933.25 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,230.27 | Professional | None | $851.14 | $851.14 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,311.31 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,905.46 | Professional | None | $891.25 | $1,071.52 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $17,782.79 | Facility | None | $1,479.11 | $3,467.37 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,479.11 | Professional | None | $758.58 | $758.58 | $1,479.11 |
Hometown Health Setting Professional Modifier None Typical Low $19.50 Median $912.01 Typical High $1,380.38 | Professional | None | $19.50 | $912.01 | $1,380.38 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $1,174.90 | Professional | None | $16.98 | $16.98 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $4,265.80 | Facility | None | $794.33 | $794.33 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $6,165.95 | Facility | None | $1,698.24 | $2,630.27 | $6,165.95 |
United Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,412.54 | Professional | None | $794.33 | $954.99 | $1,412.54 |
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 $426.58 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $660.69 |
Where Nevada sits
The same service costs 4.2 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 $11,551MT $2,762
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.