How much rates vary
Facilitymedian $11,220 · 10th to 90th $1,820 to $21,380Professionalmedian $1,202 · 10th to 90th $871 to $1,950
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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Professional | None | $870.96 | $870.96 | $1,122.02 |
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 $1,000.00 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,412.54 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,677.35 Typical High $8,912.51 | Facility | None | $691.83 | $4,677.35 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $891.25 | $1,071.52 | $1,513.56 |
Denver HMP Setting Facility Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,819.70 | Facility | None | $870.96 | $1,122.02 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,621.81 | Professional | None | $812.83 | $1,071.52 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $1,621.81 Typical High $7,762.47 | Facility | None | $812.83 | $1,621.81 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,202.26 | Professional | None | $812.83 | $912.01 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,778.28 | Professional | None | $851.14 | $1,122.02 | $1,778.28 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $616.60 |
Where Colorado sits
The same service costs 4.9 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 $12,422HI $2,542
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.