How much rates vary
Facilitymedian $12,882 · 10th to 90th $2,344 to $21,380Professionalmedian $871 · 10th to 90th $646 to $1,413
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 $977.24 Median $3,548.13 Typical High $10,715.19 | Facility | None | $977.24 | $3,548.13 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $977.24 | Professional | None | $630.96 | $645.65 | $977.24 |
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 $724.44 Median $1,047.13 Typical High $1,548.82 | Professional | None | $724.44 | $1,047.13 | $1,548.82 |
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 $645.65 Median $776.25 Typical High $1,096.48 | Professional | None | $645.65 | $776.25 | $1,096.48 |
Denver HMP Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,348.96 | Facility | None | $645.65 | $831.76 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,202.26 | Professional | None | $602.56 | $812.83 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $7,762.47 | Facility | None | $602.56 | $1,202.26 | $7,762.47 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $912.01 | Professional | None | $602.56 | $660.69 | $912.01 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,288.25 | Professional | None | $616.60 | $812.83 | $1,288.25 |
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 $323.59 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
Where Colorado sits
The same service costs 6.8 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 $13,753MT $2,023
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.