How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,202 to $13,804Professionalmedian $589 · 10th to 90th $407 to $891
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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $1,148.15 | Professional | None | $354.81 | $436.52 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $954.99 | Professional | None | $416.87 | $616.60 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $2,691.53 Typical High $5,128.61 | Facility | None | $436.52 | $2,691.53 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $758.58 | Professional | None | $426.58 | $549.54 | $758.58 |
Denver HMP Setting Facility Modifier None Typical Low $354.81 Median $524.81 Typical High $831.76 | Facility | None | $354.81 | $524.81 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $794.33 | Professional | None | $338.84 | $524.81 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $4,570.88 | Facility | None | $457.09 | $831.76 | $4,570.88 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $457.09 Typical High $891.25 | Professional | None | $218.78 | $457.09 | $891.25 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $870.96 | Professional | None | $436.52 | $588.84 | $870.96 |
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 $177.83 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $177.83 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $89.13 Typical High $95.50 | Professional | 53 · Discontinued | $70.79 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $35.48 | $43.65 | $47.86 |
Where Colorado sits
The same service costs 6.3 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 $7,350MT $1,166
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.