How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,738 to $9,772Professionalmedian $1,318 · 10th to 90th $1,000 to $2,042
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 $1,288.25 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,288.25 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,412.54 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $4,073.80 Typical High $5,888.44 | Facility | None | $1,412.54 | $4,073.80 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,047.13 | $2,137.96 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $1,047.13 Typical High $1,949.84 | Professional | None | $28.18 | $1,047.13 | $1,949.84 |
Hometown Health Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Hometown Health Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $1,737.80 | Professional | None | $20.89 | $20.89 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $4,265.80 | Facility | None | $1,148.15 | $1,148.15 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $3,019.95 | Professional | None | $933.25 | $1,148.15 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,090.30 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,318.26 | $1,949.84 |
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 $630.96 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $630.96 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $933.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $891.25 |
Where Nevada sits
The same service costs 5.0 times more in Colorado than in Kentucky. 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 $15,188KY $3,022
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.