How much rates vary
Facilitymedian $1,698 · 10th to 90th $891 to $4,365Professionalmedian $347 · 10th to 90th $191 to $603
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 $426.58 Median $1,698.24 Typical High $4,365.16 | Facility | None | $426.58 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $416.87 Typical High $457.09 | Professional | None | $190.55 | $416.87 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $426.58 Typical High $426.58 | Professional | None | $158.49 | $426.58 | $426.58 |
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 $186.21 Median $213.80 Typical High $371.54 | Professional | None | $186.21 | $213.80 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,513.56 | Facility | None | $630.96 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $380.19 Typical High $575.44 | Professional | None | $194.98 | $380.19 | $575.44 |
Hometown Health Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $870.96 | Professional | None | $147.91 | $281.84 | $870.96 |
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 $2.88 Median $257.04 Typical High $1,479.11 | Professional | None | $2.88 | $257.04 | $1,479.11 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $457.09 Typical High $4,265.80 | Facility | None | $169.82 | $457.09 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $436.52 | Professional | None | $138.04 | $257.04 | $436.52 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $3,311.31 | Facility | None | $954.99 | $1,348.96 | $3,311.31 |
United Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $660.69 | Professional | None | $234.42 | $398.11 | $660.69 |
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 $95.50 Median $165.96 Typical High $218.78 | Professional | 52 · Reduced service | $95.50 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $38.02 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $141.25 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $48.98 Typical High $66.07 | Professional | 55 · Aftercare only | $28.18 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.05 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $229.09 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $131.83 | $229.09 | $309.03 |
Where Nevada sits
The same service costs 4.6 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 $4,728MT $1,029
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.