How much rates vary
Facilitymedian $4,365 · 10th to 90th $468 to $8,318Professionalmedian $214 · 10th to 90th $79 to $525
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 $281.84 Median $3,235.94 Typical High $8,709.64 | Facility | None | $281.84 | $3,235.94 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $204.17 Typical High $309.03 | Professional | None | $75.86 | $204.17 | $309.03 |
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 $91.20 Median $269.15 Typical High $575.44 | Professional | None | $91.20 | $269.15 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $512.86 Typical High $2,691.53 | Facility | None | $331.13 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $416.87 | Professional | None | $79.43 | $199.53 | $416.87 |
Denver HMP Setting Facility Modifier None Typical Low $75.86 Median $239.88 Typical High $407.38 | Facility | None | $75.86 | $239.88 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $251.19 Typical High $549.54 | Professional | None | $89.13 | $251.19 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $144.54 Median $407.38 Typical High $676.08 | Facility | None | $144.54 | $407.38 | $676.08 |
Select Health Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $323.59 | Professional | None | $63.10 | $93.33 | $323.59 |
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 $81.28 Median $204.17 Typical High $416.87 | Professional | None | $81.28 | $204.17 | $416.87 |
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 $38.02 Median $91.20 Typical High $141.25 | Professional | 52 · Reduced service | $38.02 | $91.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $37.15 Typical High $56.23 | Professional | 53 · Discontinued | $15.49 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $138.04 Typical High $213.80 | Professional | 54 · Surgery only | $57.54 | $138.04 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $27.54 Typical High $42.66 | Professional | 55 · Aftercare only | $11.48 | $27.54 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $18.62 Typical High $28.18 | Professional | 56 · Pre-op care only | $7.59 | $18.62 | $28.18 |
Where Colorado sits
The same service costs 9.0 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 $4,579MT $507
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.