How much rates vary
Facilitymedian $12,882 · 10th to 90th $2,570 to $21,380Professionalmedian $1,479 · 10th to 90th $1,072 to $2,399
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 $12,882.50 | Facility | None | $2,570.40 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,071.52 | $1,548.82 |
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 $1,230.27 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,737.80 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,011.87 Typical High $7,079.46 | Facility | None | $1,318.26 | $5,011.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,318.26 | $1,862.09 |
Denver HMP Setting Facility Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,238.72 | Facility | None | $1,071.52 | $1,380.38 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,949.84 | Professional | None | $977.24 | $1,318.26 | $1,949.84 |
Select Health Setting Facility Modifier None Typical Low $977.24 Median $1,949.84 Typical High $6,165.95 | Facility | None | $977.24 | $1,949.84 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,479.11 | Professional | None | $977.24 | $1,122.02 | $1,479.11 |
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 $1,071.52 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,380.38 | $2,187.76 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $758.58 |
Where Colorado sits
The same service costs 4.2 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 $14,362MT $3,396
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.