How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $12,023Professionalmedian $363 · 10th to 90th $275 to $575
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 $457.09 Median $3,388.44 Typical High $9,120.11 | Facility | None | $457.09 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $1,584.89 | Professional | None | $245.47 | $288.40 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $602.56 | Professional | None | $288.40 | $407.38 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,235.94 | Facility | None | $588.84 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $501.19 | Professional | None | $275.42 | $363.08 | $501.19 |
Denver HMP Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $524.81 | Facility | None | $288.40 | $354.81 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $446.68 | Professional | None | $213.80 | $302.00 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $2,818.38 | Facility | None | $213.80 | $426.58 | $2,818.38 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $416.87 | Professional | None | $147.91 | $213.80 | $416.87 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $562.34 | Professional | None | $281.84 | $354.81 | $562.34 |
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 $138.04 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $138.04 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $60.26 | Professional | 53 · Discontinued | $54.95 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $223.87 | Professional | 54 · Surgery only | $204.17 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $44.67 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $30.20 |
Where Colorado sits
The same service costs 8.5 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 $6,252MT $735
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.