How much rates vary
Facilitymedian $12,882 · 10th to 90th $2,512 to $21,380Professionalmedian $1,778 · 10th to 90th $1,288 to $2,884
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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,445.44 | $2,089.30 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $4,073.80 Typical High $7,079.46 | Facility | None | $933.25 | $4,073.80 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,584.89 | $2,238.72 |
Denver HMP Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,691.53 | Facility | None | $1,288.25 | $1,659.59 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,584.89 | $2,398.83 |
Select Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,398.83 Typical High $6,165.95 | Facility | None | $1,174.90 | $2,398.83 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,348.96 | $1,778.28 |
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 Typical Low $1,288.25 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,659.59 | $2,630.27 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $912.01 |
Where Colorado sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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 $14,661HI $3,664
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.