How much rates vary
Facilitymedian $6,761 · 10th to 90th $2,512 to $13,183Professionalmedian $389 · 10th to 90th $275 to $550
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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $407.38 | Professional | None | $275.42 | $275.42 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $575.44 | Professional | None | $309.03 | $407.38 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,073.80 Typical High $6,456.54 | Facility | None | $691.83 | $4,073.80 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $512.86 | Professional | None | $316.23 | $389.05 | $512.86 |
Denver HMP Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $630.96 | Facility | None | $275.42 | $389.05 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $549.54 | Professional | None | $275.42 | $346.74 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $5,623.41 | Facility | None | $251.19 | $501.19 | $5,623.41 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $467.74 | Professional | None | $223.87 | $269.15 | $467.74 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $575.44 | Professional | None | $302.00 | $380.19 | $575.44 |
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 $138.04 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $138.04 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | 53 · Discontinued | $54.95 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $34.67 |
Where Colorado sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.