How much rates vary
Facilitymedian $4,169 · 10th to 90th $589 to $8,511Professionalmedian $182 · 10th to 90th $89 to $363
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 $102.33 Median $3,090.30 Typical High $7,762.47 | Facility | None | $102.33 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $169.82 Typical High $302.00 | Professional | None | $72.44 | $169.82 | $302.00 |
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 $95.50 Median $204.17 Typical High $371.54 | Professional | None | $95.50 | $204.17 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,659.59 Typical High $2,344.23 | Facility | None | $676.08 | $1,659.59 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $309.03 | Professional | None | $95.50 | $177.83 | $309.03 |
Denver HMP Setting Facility Modifier None Typical Low $72.44 Median $158.49 Typical High $281.84 | Facility | None | $72.44 | $158.49 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $309.03 | Professional | None | $69.18 | $147.91 | $309.03 |
Select Health Setting Facility Modifier None Typical Low $125.89 Median $338.84 Typical High $2,089.30 | Facility | None | $125.89 | $338.84 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $43.65 Median $123.03 Typical High $363.08 | Professional | None | $43.65 | $123.03 | $363.08 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $338.84 | Professional | None | $95.50 | $194.98 | $338.84 |
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 $36.31 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $36.31 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $14.45 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $112.20 Typical High $131.83 | Professional | 54 · Surgery only | $54.95 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $10.96 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.24 | $14.79 | $17.38 |
Where Colorado sits
The same service costs 9.7 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 $4,351MT $447
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.