How much rates vary
Facilitymedian $3,715 · 10th to 90th $692 to $8,318Professionalmedian $427 · 10th to 90th $219 to $955
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 $251.19 Median $2,570.40 Typical High $8,912.51 | Facility | None | $251.19 | $2,570.40 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $691.83 | Professional | None | $194.98 | $371.54 | $691.83 |
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 $234.42 Median $524.81 Typical High $1,000.00 | Professional | None | $234.42 | $524.81 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,288.25 Typical High $2,187.76 | Facility | None | $588.84 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $776.25 | Professional | None | $234.42 | $323.59 | $776.25 |
Denver HMP Setting Facility Modifier None Typical Low $194.98 Median $302.00 Typical High $933.25 | Facility | None | $194.98 | $302.00 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $524.81 Typical High $977.24 | Professional | None | $218.78 | $524.81 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $1,047.13 Typical High $1,479.11 | Facility | None | $346.74 | $1,047.13 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $575.44 | Professional | None | $162.18 | $229.09 | $575.44 |
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 $223.87 Median $380.19 Typical High $812.83 | Professional | None | $223.87 | $380.19 | $812.83 |
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 $162.18 Typical High $257.04 | Professional | 52 · Reduced service | $97.72 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $64.57 Typical High $102.33 | Professional | 53 · Discontinued | $38.90 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $239.88 Typical High $389.05 | Professional | 54 · Surgery only | $147.91 | $239.88 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $48.98 Typical High $77.62 | Professional | 55 · Aftercare only | $29.51 | $48.98 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $32.36 Typical High $51.29 | Professional | 56 · Pre-op care only | $19.50 | $32.36 | $51.29 |
Where Colorado sits
The same service costs 4.1 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 $4,142MT $1,002
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.