How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,514 to $36,308Professionalmedian $324 · 10th to 90th $123 to $2,239
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 $758.58 Median $2,089.30 Typical High $10,715.19 | Facility | None | $758.58 | $2,089.30 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $2,238.72 | Professional | None | $316.23 | $323.59 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $22,908.68 Typical High $45,708.82 | Facility | None | $10,964.78 | $22,908.68 | $45,708.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $537.03 | Professional | None | $316.23 | $363.08 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $6,309.57 Typical High $8,709.64 | Facility | None | $691.83 | $6,309.57 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $2,137.96 | Professional | None | $123.03 | $165.96 | $2,137.96 |
Hometown Health Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $4,168.69 | Professional | None | $102.33 | $223.87 | $4,168.69 |
Hometown Health Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
Hometown Health Setting Professional Modifier None Typical Low $2.14 Median $436.52 Typical High $9,120.11 | Professional | None | $2.14 | $436.52 | $9,120.11 |
Select Health Setting Facility Modifier None Typical Low $288.40 Median $2,238.72 Typical High $4,265.80 | Facility | None | $288.40 | $2,238.72 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $2,089.30 | Professional | None | $234.42 | $436.52 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $11,481.54 | Facility | None | $1,905.46 | $3,162.28 | $11,481.54 |
United Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $2,238.72 | Professional | None | $120.23 | $245.47 | $2,238.72 |
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 $158.49 Median $162.18 Typical High $1,096.48 | Professional | 52 · Reduced service | $158.49 | $162.18 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $446.68 | Professional | 53 · Discontinued | $63.10 | $64.57 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $245.47 Typical High $1,659.59 | Professional | 54 · Surgery only | $239.88 | $245.47 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $331.13 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $223.87 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $229.09 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $223.87 | $229.09 | $1,548.82 |
Where Nevada sits
The same service costs 13.1 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 $15,603MT $1,192
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.