How much rates vary
Facilitymedian $12,882 · 10th to 90th $2,239 to $21,380Professionalmedian $1,000 · 10th to 90th $724 to $1,622
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 $933.25 Median $3,235.94 Typical High $10,715.19 | Facility | None | $933.25 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $1,348.96 | Professional | None | $707.95 | $724.44 | $1,348.96 |
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 $831.76 Median $1,174.90 Typical High $1,737.80 | Professional | None | $831.76 | $1,174.90 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $9,120.11 | Facility | None | $691.83 | $4,786.30 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,258.93 | Professional | None | $724.44 | $891.25 | $1,258.93 |
Denver HMP Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $1,513.56 | Facility | None | $724.44 | $954.99 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,348.96 | Professional | None | $676.08 | $891.25 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $8,128.31 | Facility | None | $676.08 | $1,348.96 | $8,128.31 |
Select Health Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,000.00 | Professional | None | $676.08 | $741.31 | $1,000.00 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,165.95 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,165.95 | $15,488.17 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,479.11 | Professional | None | $724.44 | $933.25 | $1,479.11 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Where Colorado sits
The same service costs 6.1 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 $13,882MT $2,270
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.