How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,738 to $9,772Professionalmedian $1,230 · 10th to 90th $955 to $1,995
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 $1,230.27 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,230.27 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,230.27 | $1,230.27 |
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 $1,174.90 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,348.96 | $2,187.76 |
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 $933.25 Median $1,000.00 Typical High $2,089.30 | Professional | None | $933.25 | $1,000.00 | $2,089.30 |
Hometown Health Setting Professional Modifier None Typical Low $26.30 Median $1,047.13 Typical High $1,949.84 | Professional | None | $26.30 | $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 $19.95 Median $19.95 Typical High $1,737.80 | Professional | None | $19.95 | $19.95 | $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 $2,951.21 | Professional | None | $933.25 | $1,148.15 | $2,951.21 |
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 $1,023.29 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,230.27 | $1,862.09 |
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 $602.56 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $602.56 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $912.01 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $870.96 |
Where Nevada sits
The same service costs 5.5 times more in Colorado than in West Virginia. 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 $14,842WV $2,709
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.