How much rates vary
Facilitymedian $12,882 · 10th to 90th $2,089 to $21,380Professionalmedian $955 · 10th to 90th $692 to $1,514
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 $691.83 Median $691.83 Typical High $1,000.00 | Professional | None | $691.83 | $691.83 | $1,000.00 |
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 $794.33 Median $1,122.02 Typical High $1,659.59 | Professional | None | $794.33 | $1,122.02 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,677.35 Typical High $9,120.11 | Facility | None | $691.83 | $4,677.35 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,288.25 | Professional | None | $724.44 | $891.25 | $1,288.25 |
Denver HMP Setting Facility Modifier None Typical Low $691.83 Median $954.99 Typical High $1,445.44 | Facility | None | $691.83 | $954.99 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,258.93 | Professional | None | $630.96 | $851.14 | $1,258.93 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $7,943.28 | Facility | None | $630.96 | $1,258.93 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $954.99 | Professional | None | $630.96 | $707.95 | $954.99 |
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 $707.95 Median $912.01 Typical High $1,380.38 | Professional | None | $707.95 | $912.01 | $1,380.38 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $478.63 |
Where Colorado sits
The same service costs 6.4 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 $13,837MT $2,168
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.