How much rates vary
Facilitymedian $3,981 · 10th to 90th $851 to $8,511Professionalmedian $339 · 10th to 90th $251 to $501
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 $251.19 Median $251.19 Typical High $389.05 | Professional | None | $251.19 | $251.19 | $389.05 |
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 $275.42 Median $371.54 Typical High $524.81 | Professional | None | $275.42 | $371.54 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $1,047.13 Typical High $3,311.31 | Facility | None | $724.44 | $1,047.13 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $489.78 | Professional | None | $281.84 | $331.13 | $489.78 |
Denver HMP Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $549.54 | Facility | None | $251.19 | $309.03 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $478.63 | Professional | None | $245.47 | $309.03 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $218.78 Median $436.52 Typical High $1,096.48 | Facility | None | $218.78 | $436.52 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $407.38 | Professional | None | $204.17 | $239.88 | $407.38 |
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 $263.03 Median $346.74 Typical High $512.86 | Professional | None | $263.03 | $346.74 | $512.86 |
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 $123.03 Median $123.03 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $269.15 | Professional | 54 · Surgery only | $186.21 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $35.48 |
Where Colorado sits
The same service costs 5.6 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 $4,320MT $769
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.