How much rates vary
Facilitymedian $1,698 · 10th to 90th $759 to $4,365Professionalmedian $380 · 10th to 90th $269 to $589
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 $363.08 Median $1,698.24 Typical High $4,466.84 | Facility | None | $363.08 | $1,698.24 | $4,466.84 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $380.19 | Professional | None | $354.81 | $363.08 | $380.19 |
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 $354.81 Median $407.38 Typical High $660.69 | Professional | None | $354.81 | $407.38 | $660.69 |
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 $263.03 Median $302.00 Typical High $616.60 | Professional | None | $263.03 | $302.00 | $616.60 |
Hometown Health Setting Professional Modifier None Typical Low $7.94 Median $331.13 Typical High $616.60 | Professional | None | $7.94 | $331.13 | $616.60 |
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 $6.03 Median $6.03 Typical High $549.54 | Professional | None | $6.03 | $6.03 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $4,265.80 | Facility | None | $363.08 | $363.08 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $741.31 | Professional | None | $295.12 | $363.08 | $741.31 |
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 $288.40 Median $389.05 Typical High $562.34 | Professional | None | $288.40 | $389.05 | $562.34 |
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 $177.83 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $251.19 | $257.04 | $257.04 |
Where Nevada sits
The same service costs 4.0 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 $4,866MT $1,221
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.