How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,951 to $13,183Professionalmedian $447 · 10th to 90th $339 to $6,310
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 $5,888.44 Median $8,128.31 Typical High $26,302.68 | Professional | None (both parts) | $5,888.44 | $8,128.31 | $26,302.68 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $269.15 Median $275.42 Typical High $295.12 | Professional | 26 · Professional part | $269.15 | $275.42 | $295.12 |
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 $630.96 Median $1,412.54 Typical High $3,548.13 | Professional | None (both parts) | $630.96 | $1,412.54 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $295.12 Median $389.05 Typical High $602.56 | Professional | 26 · Professional part | $295.12 | $389.05 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $11,481.54 Typical High $12,882.50 | Facility | None | $5,370.32 | $11,481.54 | $12,882.50 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $323.59 Median $398.11 Typical High $537.03 | Professional | 26 · Professional part | $323.59 | $398.11 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $275.42 Median $316.23 Typical High $398.11 | Facility | None | $275.42 | $316.23 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,570.88 Median $5,495.41 Typical High $5,754.40 | Professional | None | $4,570.88 | $5,495.41 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $363.08 Typical High $537.03 | Professional | 26 · Professional part | $245.47 | $363.08 | $537.03 |
Select Health Setting Facility Modifier 26 · Professional part Typical Low $257.04 Median $478.63 Typical High $537.03 | Facility | 26 · Professional part | $257.04 | $478.63 | $537.03 |
Select Health Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $181.97 Typical High $257.04 | Professional | 26 · Professional part | $181.97 | $181.97 | $257.04 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None (both parts) Typical Low $338.84 Median $407.38 Typical High $676.08 | Professional | None (both parts) | $338.84 | $407.38 | $676.08 |
United Setting Professional Modifier 26 · Professional part Typical Low $338.84 Median $407.38 Typical High $676.08 | Professional | 26 · Professional part | $338.84 | $407.38 | $676.08 |
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 $134.90 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $204.17 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $26.92 | $27.54 | $27.54 |
Where Colorado sits
The same service costs 19.5 times more in Colorado than in Maryland. 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
$6,761
CO $6,761MD $347
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.