How much rates vary
Facilitymedian $3,802 · 10th to 90th $813 to $8,318Professionalmedian $288 · 10th to 90th $148 to $741
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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $436.52 | Professional | None | $131.83 | $213.80 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $8,912.51 | Facility | None | $2,137.96 | $5,248.07 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $398.11 Typical High $794.33 | Professional | None | $158.49 | $398.11 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,258.93 Typical High $1,698.24 | Facility | None | $436.52 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $588.84 | Professional | None | $154.88 | $213.80 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $724.44 | Facility | None | $131.83 | $199.53 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $741.31 | Professional | None | $147.91 | $346.74 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $234.42 Median $812.83 Typical High $1,479.11 | Facility | None | $234.42 | $812.83 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $436.52 | Professional | None | $107.15 | $151.36 | $436.52 |
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 $151.36 Median $257.04 Typical High $616.60 | Professional | None | $151.36 | $257.04 | $616.60 |
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 $66.07 Median $107.15 Typical High $194.98 | Professional | 52 · Reduced service | $66.07 | $107.15 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $42.66 Typical High $79.43 | Professional | 53 · Discontinued | $26.30 | $42.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $162.18 Typical High $295.12 | Professional | 54 · Surgery only | $97.72 | $162.18 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $32.36 Typical High $58.88 | Professional | 55 · Aftercare only | $19.50 | $32.36 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.38 Typical High $38.90 | Professional | 56 · Pre-op care only | $13.18 | $21.38 | $38.90 |
Where Colorado sits
The same service costs 5.7 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 $4,090MT $722
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.