How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,230 to $11,482Professionalmedian $457 · 10th to 90th $309 to $794
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 $1,258.93 Median $3,388.44 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $549.54 | Professional | None | $288.40 | $389.05 | $549.54 |
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 $346.74 Median $501.19 Typical High $912.01 | Professional | None | $346.74 | $501.19 | $912.01 |
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 $316.23 Median $416.87 Typical High $602.56 | Professional | None | $316.23 | $416.87 | $602.56 |
Denver HMP Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $602.56 | Facility | None | $295.12 | $416.87 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $724.44 | Professional | None | $281.84 | $457.09 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $2,089.30 | Facility | None | $426.58 | $794.33 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $426.58 | Professional | None | $177.83 | $316.23 | $426.58 |
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 $316.23 Median $446.68 Typical High $758.58 | Professional | None | $316.23 | $446.68 | $758.58 |
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 $147.91 Median $177.83 Typical High $208.93 | Professional | 52 · Reduced service | $147.91 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $58.88 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $218.78 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $43.65 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $35.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $29.51 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $204.17 | $245.47 | $288.40 |
Where Colorado sits
The same service costs 6.1 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 $6,346MT $1,043
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.