How much rates vary
Facilitymedian $7,586 · 10th to 90th $4,467 to $16,218Professionalmedian $316 · 10th to 90th $240 to $6,166
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 $3,090.30 Median $6,165.95 Typical High $13,489.63 | Facility | None | $3,090.30 | $6,165.95 | $13,489.63 |
Aetna Setting Professional Modifier None (both parts) Typical Low $190.55 Median $8,128.31 Typical High $26,302.68 | Professional | None (both parts) | $190.55 | $8,128.31 | $26,302.68 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $190.55 Median $199.53 Typical High $281.84 | Professional | 26 · Professional part | $190.55 | $199.53 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,079.46 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,079.46 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $338.84 Median $645.65 Typical High $1,659.59 | Professional | None (both parts) | $338.84 | $645.65 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $275.42 Typical High $436.52 | Professional | 26 · Professional part | $208.93 | $275.42 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $5,248.07 Median $9,332.54 Typical High $12,882.50 | Facility | None | $5,248.07 | $9,332.54 | $12,882.50 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $281.84 Typical High $380.19 | Professional | 26 · Professional part | $229.09 | $281.84 | $380.19 |
Denver HMP Setting Facility Modifier None Typical Low $199.53 Median $223.87 Typical High $288.40 | Facility | None | $199.53 | $223.87 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $5,754.40 | Professional | None | $724.44 | $724.44 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $263.03 Typical High $398.11 | Professional | 26 · Professional part | $181.97 | $263.03 | $398.11 |
Select Health Setting Facility Modifier 26 · Professional part Typical Low $190.55 Median $354.81 Typical High $398.11 | Facility | 26 · Professional part | $190.55 | $354.81 | $398.11 |
Select Health Setting Professional Modifier 26 · Professional part Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | 26 · Professional part | $131.83 | $131.83 | $190.55 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $22,387.21 | Facility | None | $4,570.88 | $10,000.00 | $22,387.21 |
United Setting Professional Modifier None (both parts) Typical Low $239.88 Median $288.40 Typical High $478.63 | Professional | None (both parts) | $239.88 | $288.40 | $478.63 |
United Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $288.40 Typical High $478.63 | Professional | 26 · Professional part | $239.88 | $288.40 | $478.63 |
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 $95.50 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $95.50 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $28.84 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.05 | $19.95 | $19.95 |
Where Colorado sits
The same service costs 28.8 times more in Colorado than in Kentucky. 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.
Colorado· 1st of 51
$7,079
CO $7,079KY $245
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.