How much rates vary
Facilitymedian $1,950 · 10th to 90th $724 to $4,467Professionalmedian $562 · 10th to 90th $437 to $851
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 $562.34 Median $2,238.72 Typical High $5,011.87 | Facility | None | $562.34 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $724.44 | Professional | None | $467.74 | $602.56 | $724.44 |
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 $446.68 Median $512.86 Typical High $741.31 | Professional | None | $446.68 | $512.86 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,148.15 Typical High $1,659.59 | Facility | None | $501.19 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $870.96 | Professional | None | $389.05 | $602.56 | $870.96 |
Hometown Health Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $1,047.13 | Professional | None | $512.86 | $630.96 | $1,047.13 |
Hometown Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Hometown Health Setting Professional Modifier None Typical Low $8.32 Median $588.84 Typical High $1,698.24 | Professional | None | $8.32 | $588.84 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $4,265.80 | Facility | None | $398.11 | $588.84 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $831.76 | Professional | None | $371.54 | $588.84 | $831.76 |
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 $426.58 Median $549.54 Typical High $812.83 | Professional | None | $426.58 | $549.54 | $812.83 |
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 $234.42 Median $281.84 Typical High $363.08 | Professional | 52 · Reduced service | $234.42 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $144.54 | Professional | 53 · Discontinued | $93.33 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $354.81 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $72.44 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $389.05 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $331.13 | $389.05 | $501.19 |
Where Nevada sits
The same service costs 3.2 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 $4,996MT $1,537
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.