How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $11,482Professionalmedian $562 · 10th to 90th $363 to $933
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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $588.84 | Professional | None | $346.74 | $524.81 | $588.84 |
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 $407.38 Median $575.44 Typical High $851.14 | Professional | None | $407.38 | $575.44 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,090.30 | Facility | None | $588.84 | $2,187.76 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $933.25 | Professional | None | $380.19 | $575.44 | $933.25 |
Denver HMP Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $812.83 | Facility | None | $346.74 | $549.54 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $933.25 | Professional | None | $389.05 | $602.56 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $1,023.29 Typical High $2,754.23 | Facility | None | $549.54 | $1,023.29 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $549.54 | Professional | None | $338.84 | $426.58 | $549.54 |
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 $407.38 Median $645.65 Typical High $1,148.15 | Professional | None | $407.38 | $645.65 | $1,148.15 |
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 $173.78 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $173.78 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $100.00 Typical High $104.71 | Professional | 53 · Discontinued | $69.18 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $380.19 Typical High $398.11 | Professional | 54 · Surgery only | $257.04 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $75.86 Typical High $79.43 | Professional | 55 · Aftercare only | $51.29 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $50.12 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $354.81 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $239.88 | $354.81 | $371.54 |
Where Colorado sits
The same service costs 4.4 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 $6,451MT $1,460
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.