How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,259 to $8,710Professionalmedian $316 · 10th to 90th $251 to $562
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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $407.38 | Professional | None | $257.04 | $302.00 | $407.38 |
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 $275.42 Median $363.08 Typical High $616.60 | Professional | None | $275.42 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,479.11 Typical High $2,041.74 | Facility | None | $436.52 | $1,479.11 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $436.52 | Professional | None | $245.47 | $309.03 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $338.84 Typical High $524.81 | Facility | None | $239.88 | $338.84 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $416.87 | Professional | None | $208.93 | $269.15 | $416.87 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $416.87 Typical High $1,819.70 | Facility | None | $208.93 | $416.87 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $302.00 | Professional | None | $144.54 | $251.19 | $302.00 |
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 $245.47 Median $331.13 Typical High $512.86 | Professional | None | $245.47 | $331.13 | $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 $128.82 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $38.90 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $30.20 |
Where Colorado sits
The same service costs 6.4 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 $4,783MT $743
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.