How much rates vary
Facilitymedian $1,549 · 10th to 90th $468 to $4,365Professionalmedian $275 · 10th to 90th $219 to $575
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 $257.04 Median $1,698.24 Typical High $4,466.84 | Facility | None | $257.04 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | None | $251.19 | $257.04 | $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 $251.19 Median $288.40 Typical High $478.63 | Professional | None | $251.19 | $288.40 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $776.25 Typical High $1,122.02 | Facility | None | $398.11 | $776.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $501.19 | Professional | None | $218.78 | $263.03 | $501.19 |
Hometown Health Setting Professional Modifier None Typical Low $13.49 Median $218.78 Typical High $436.52 | Professional | None | $13.49 | $218.78 | $436.52 |
Hometown Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Hometown Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $331.13 | Professional | None | $10.00 | $10.00 | $331.13 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $4,265.80 | Facility | None | $218.78 | $218.78 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $354.81 | Professional | None | $173.78 | $218.78 | $354.81 |
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 $234.42 Median $323.59 Typical High $758.58 | Professional | None | $234.42 | $323.59 | $758.58 |
5 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 $125.89 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $50.12 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $25.70 |
Where Nevada sits
The same service costs 6.0 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 $4,737MT $787
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.