How much rates vary
Facilitymedian $1,660 · 10th to 90th $794 to $4,365Professionalmedian $603 · 10th to 90th $398 to $1,000
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 $501.19 Median $1,698.24 Typical High $4,365.16 | Facility | None | $501.19 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $812.83 | Professional | None | $489.78 | $724.44 | $812.83 |
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 $478.63 Median $549.54 Typical High $891.25 | Professional | None | $478.63 | $549.54 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $1,445.44 | Facility | None | $398.11 | $1,000.00 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,000.00 | Professional | None | $398.11 | $645.65 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $1,230.27 | Professional | None | $338.84 | $602.56 | $1,230.27 |
Hometown Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Hometown Health Setting Professional Modifier None Typical Low $3.31 Median $660.69 Typical High $1,479.11 | Professional | None | $3.31 | $660.69 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $436.52 Median $851.14 Typical High $4,265.80 | Facility | None | $436.52 | $851.14 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $812.83 | Professional | None | $346.74 | $660.69 | $812.83 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,318.26 Typical High $3,311.31 | Facility | None | $954.99 | $1,318.26 | $3,311.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $1,023.29 | Professional | None | $389.05 | $645.65 | $1,023.29 |
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 $245.47 Median $331.13 Typical High $407.38 | Professional | 52 · Reduced service | $245.47 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $100.00 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $371.54 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $100.00 Typical High $123.03 | Professional | 55 · Aftercare only | $74.13 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $66.07 Typical High $81.28 | Professional | 56 · Pre-op care only | $50.12 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $467.74 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $346.74 | $467.74 | $575.44 |
Where Nevada sits
The same service costs 3.0 times more in Colorado than in Maryland. 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 $5,106MD $1,697
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.