How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,738 to $9,772Professionalmedian $1,445 · 10th to 90th $1,072 to $2,138
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 $1,318.26 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,318.26 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,318.26 | $1,380.38 |
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 $1,288.25 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,479.11 | $2,344.23 |
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 $1,071.52 Median $1,096.48 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,096.48 | $2,290.87 |
Hometown Health Setting Professional Modifier None Typical Low $28.18 Median $1,071.52 Typical High $1,995.26 | Professional | None | $28.18 | $1,071.52 | $1,995.26 |
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 $1,778.28 | Professional | None | $20.89 | $20.89 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,265.80 | Facility | None | $1,202.26 | $1,202.26 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $3,090.30 | Professional | None | $954.99 | $1,202.26 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,162.28 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,479.11 | $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 $645.65 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $933.25 |
Where Nevada sits
The same service costs 4.7 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 $15,002KY $3,224
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.