How much rates vary
Facilitymedian $4,571 · 10th to 90th $851 to $8,913Professionalmedian $331 · 10th to 90th $251 to $513
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 Typical Low $229.09 Median $263.03 Typical High $380.19 | Professional | None | $229.09 | $263.03 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $524.81 | Professional | None | $251.19 | $331.13 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $467.74 | Professional | None | $269.15 | $338.84 | $467.74 |
Denver HMP Setting Facility Modifier None Typical Low $263.03 Median $288.40 Typical High $524.81 | Facility | None | $263.03 | $288.40 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $446.68 | Professional | None | $199.53 | $302.00 | $446.68 |
Select Health Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $446.68 | Facility | None | $213.80 | $426.58 | $446.68 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $213.80 | Professional | None | $147.91 | $147.91 | $213.80 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $588.84 | Professional | None | $295.12 | $389.05 | $588.84 |
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 $125.89 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $125.89 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $52.48 Typical High $70.79 | Professional | 53 · Discontinued | $51.29 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $263.03 | Professional | 54 · Surgery only | $190.55 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $53.70 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $35.48 |
Where Colorado sits
The same service costs 7.3 times more in Alaska 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
AK $5,199MT $710
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.