How much rates vary
Facilitymedian $5,623 · 10th to 90th $933 to $10,965Professionalmedian $288 · 10th to 90th $186 to $513
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 $269.15 Median $3,162.28 Typical High $8,912.51 | Facility | None | $269.15 | $3,162.28 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $446.68 | Professional | None | $177.83 | $263.03 | $446.68 |
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 $213.80 Median $331.13 Typical High $602.56 | Professional | None | $213.80 | $331.13 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $2,454.71 | Facility | None | $588.84 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $398.11 | Professional | None | $186.21 | $251.19 | $398.11 |
Denver HMP Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $426.58 | Facility | None | $181.97 | $269.15 | $426.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $501.19 | Professional | None | $194.98 | $309.03 | $501.19 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $549.54 Typical High $2,089.30 | Facility | None | $295.12 | $549.54 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $295.12 | Professional | None | $125.89 | $218.78 | $295.12 |
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 $194.98 Median $275.42 Typical High $457.09 | Professional | None | $194.98 | $275.42 | $457.09 |
6 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 $91.20 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $91.20 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $36.31 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $138.04 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $128.82 | $158.49 | $190.55 |
Where Colorado sits
The same service costs 9.3 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 $5,912MT $637
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.