How much rates vary
Facilitymedian $4,365 · 10th to 90th $832 to $8,511Professionalmedian $316 · 10th to 90th $204 to $479
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 $2,187.76 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,187.76 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $6,025.60 | Professional | None | $194.98 | $194.98 | $6,025.60 |
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 $234.42 Median $331.13 Typical High $478.63 | Professional | None | $234.42 | $331.13 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,691.53 | Facility | None | $758.58 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $436.52 | Professional | None | $245.47 | $323.59 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $467.74 | Facility | None | $194.98 | $281.84 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $363.08 | Professional | None | $173.78 | $245.47 | $363.08 |
Select Health Setting Facility Modifier None Typical Low $173.78 Median $346.74 Typical High $1,412.54 | Facility | None | $173.78 | $346.74 | $1,412.54 |
Select Health Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $338.84 | Professional | None | $120.23 | $173.78 | $338.84 |
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 $234.42 Median $354.81 Typical High $501.19 | Professional | None | $234.42 | $354.81 | $501.19 |
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 $97.72 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $97.72 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | 54 · Surgery only | $147.91 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $22.91 |
Where Colorado sits
The same service costs 7.6 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 $4,681MT $618
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.