How much rates vary
Facilitymedian $2,570 · 10th to 90th $74 to $8,710Professionalmedian $105 · 10th to 90th $69 to $155
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None (both parts) Typical Low $69.18 Median $74.13 Typical High $77.62 | Professional | None (both parts) | $69.18 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $27.54 Typical High $28.84 | Professional | 26 · Professional part | $26.92 | $27.54 | $28.84 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $46.77 Typical High $47.86 | Professional | TC · Technical part | $41.69 | $46.77 | $47.86 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $75.86 Median $109.65 Typical High $169.82 | Professional | None (both parts) | $75.86 | $109.65 | $169.82 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $41.69 Typical High $63.10 | Professional | 26 · Professional part | $31.62 | $41.69 | $63.10 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $52.48 Median $72.44 Typical High $107.15 | Professional | TC · Technical part | $52.48 | $72.44 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | None (both parts) | $100.00 | $117.49 | $117.49 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $74.13 Typical High $104.71 | Facility | None | $72.44 | $74.13 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $147.91 | Professional | None | $58.88 | $91.20 | $147.91 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $40.74 Typical High $64.57 | Professional | 26 · Professional part | $26.92 | $40.74 | $64.57 |
Kaiser Permanente Setting Professional Modifier TC · Technical part Typical Low $32.36 Median $50.12 Typical High $79.43 | Professional | TC · Technical part | $32.36 | $50.12 | $79.43 |
Select Health Setting Facility Modifier None Typical Low $69.18 Median $128.82 Typical High $147.91 | Facility | None | $69.18 | $128.82 | $147.91 |
Select Health Setting Professional Modifier None (both parts) Typical Low $53.70 Median $69.18 Typical High $100.00 | Professional | None (both parts) | $53.70 | $69.18 | $100.00 |
Select Health Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $31.62 Typical High $45.71 | Professional | 26 · Professional part | $23.99 | $31.62 | $45.71 |
Select Health Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $38.02 Typical High $54.95 | Professional | TC · Technical part | $29.51 | $38.02 | $54.95 |
United Setting Facility Modifier None Typical Low $162.18 Median $169.82 Typical High $194.98 | Facility | None | $162.18 | $169.82 | $194.98 |
United Setting Professional Modifier None (both parts) Typical Low $81.28 Median $104.71 Typical High $154.88 | Professional | None (both parts) | $81.28 | $104.71 | $154.88 |
United Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $40.74 Typical High $60.26 | Professional | 26 · Professional part | $32.36 | $40.74 | $60.26 |
United Setting Professional Modifier TC · Technical part Typical Low $48.98 Median $63.10 Typical High $95.50 | Professional | TC · Technical part | $48.98 | $63.10 | $95.50 |
5 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 $34.67 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $34.67 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $13.80 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $54.95 Typical High $57.54 | Professional | 54 · Surgery only | $51.29 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $11.48 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $7.76 |
Where Colorado sits
The same service costs 4.4 times more in Texas than in New York. 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.
Colorado· 9th of 51
$105
TX $174NY $39.81
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.