How much rates vary
Facilitymedian $4,365 · 10th to 90th $692 to $8,318Professionalmedian $214 · 10th to 90th $158 to $347
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 $204.17 Median $3,235.94 Typical High $7,762.47 | Facility | None | $204.17 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $275.42 | Professional | None | $154.88 | $158.49 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $380.19 | Professional | None | $177.83 | $257.04 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,230.27 Typical High $1,659.59 | Facility | None | $436.52 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $281.84 | Professional | None | $154.88 | $190.55 | $281.84 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $346.74 | Facility | None | $158.49 | $199.53 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $316.23 | Professional | None | $162.18 | $204.17 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $309.03 Typical High $1,445.44 | Facility | None | $151.36 | $309.03 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $229.09 | Professional | None | $151.36 | $165.96 | $229.09 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $316.23 | Professional | None | $147.91 | $194.98 | $316.23 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $109.65 | $112.20 | $112.20 |
Where Colorado sits
The same service costs 9.1 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 $4,579MT $503
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.