How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $11,482Professionalmedian $380 · 10th to 90th $275 to $617
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 $954.99 Median $3,388.44 Typical High $8,709.64 | Facility | None | $954.99 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $407.38 | Professional | None | $269.15 | $275.42 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $660.69 | Professional | None | $316.23 | $446.68 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $3,090.30 | Facility | None | $436.52 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $501.19 | Professional | None | $295.12 | $354.81 | $501.19 |
Denver HMP Setting Facility Modifier None Typical Low $275.42 Median $363.08 Typical High $588.84 | Facility | None | $275.42 | $363.08 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $512.86 | Professional | None | $269.15 | $346.74 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $257.04 Median $512.86 Typical High $2,754.23 | Facility | None | $257.04 | $512.86 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $389.05 | Professional | None | $257.04 | $281.84 | $389.05 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $588.84 | Professional | None | $288.40 | $371.54 | $588.84 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $208.93 | Professional | 54 · Surgery only | $204.17 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $194.98 |
Where Colorado sits
The same service costs 7.3 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 $6,269MT $863
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.