How much rates vary
Facilitymedian $1,950 · 10th to 90th $676 to $4,467Professionalmedian $257 · 10th to 90th $170 to $437
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 $218.78 Median $2,238.72 Typical High $5,011.87 | Facility | None | $218.78 | $2,238.72 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $416.87 | Professional | None | $186.21 | $275.42 | $416.87 |
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 $177.83 Median $208.93 Typical High $295.12 | Professional | None | $177.83 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,148.15 Typical High $1,659.59 | Facility | None | $489.78 | $1,148.15 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $457.09 | Professional | None | $162.18 | $257.04 | $457.09 |
Hometown Health Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $1,023.29 | Professional | None | $199.53 | $338.84 | $1,023.29 |
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 $2.40 Median $234.42 Typical High $1,698.24 | Professional | None | $2.40 | $234.42 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $154.88 Median $331.13 Typical High $4,265.80 | Facility | None | $154.88 | $331.13 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $331.13 | Professional | None | $144.54 | $257.04 | $331.13 |
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 $154.88 Median $281.84 Typical High $436.52 | Professional | None | $154.88 | $281.84 | $436.52 |
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 $93.33 Median $138.04 Typical High $204.17 | Professional | 52 · Reduced service | $93.33 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $54.95 Typical High $83.18 | Professional | 53 · Discontinued | $37.15 | $54.95 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $204.17 Typical High $309.03 | Professional | 54 · Surgery only | $138.04 | $204.17 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $61.66 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $27.54 Typical High $41.69 | Professional | 56 · Pre-op care only | $18.62 | $27.54 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $190.55 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $128.82 | $190.55 | $288.40 |
Where Nevada sits
The same service costs 6.3 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 $4,654MT $736
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.