How much rates vary
Facilitymedian $3,890 · 10th to 90th $871 to $8,511Professionalmedian $245 · 10th to 90th $182 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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $263.03 | Professional | None | $177.83 | $181.97 | $263.03 |
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 $204.17 Median $275.42 Typical High $380.19 | Professional | None | $204.17 | $275.42 | $380.19 |
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 $208.93 Median $234.42 Typical High $354.81 | Professional | None | $208.93 | $234.42 | $354.81 |
Denver HMP Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $407.38 | Facility | None | $181.97 | $257.04 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $354.81 | Professional | None | $181.97 | $229.09 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $1,479.11 | Facility | None | $162.18 | $323.59 | $1,479.11 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $302.00 | Professional | None | $151.36 | $177.83 | $302.00 |
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 $190.55 Median $239.88 Typical High $380.19 | Professional | None | $190.55 | $239.88 | $380.19 |
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 $89.13 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $89.13 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $35.48 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $131.83 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $17.78 | $18.20 | $21.38 |
Where Colorado sits
The same service costs 7.3 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 $4,136MT $564
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.