How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,230 to $12,023Professionalmedian $550 · 10th to 90th $372 to $912
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 $549.54 Median $3,235.94 Typical High $8,912.51 | Facility | None | $549.54 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $707.95 | Professional | None | $363.08 | $549.54 | $707.95 |
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 $416.87 Median $588.84 Typical High $870.96 | Professional | None | $416.87 | $588.84 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $691.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $912.01 | Professional | None | $389.05 | $549.54 | $912.01 |
Denver HMP Setting Facility Modifier None Typical Low $363.08 Median $549.54 Typical High $851.14 | Facility | None | $363.08 | $549.54 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $977.24 | Professional | None | $426.58 | $630.96 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $1,096.48 Typical High $2,754.23 | Facility | None | $588.84 | $1,096.48 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $588.84 | Professional | None | $363.08 | $457.09 | $588.84 |
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 $398.11 Median $602.56 Typical High $1,047.13 | Professional | None | $398.11 | $602.56 | $1,047.13 |
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 $181.97 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $181.97 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $371.54 Typical High $407.38 | Professional | 54 · Surgery only | $275.42 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $54.95 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $257.04 | $354.81 | $380.19 |
Where Colorado sits
The same service costs 4.7 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 $6,438MT $1,383
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.