How much rates vary
Facilitymedian $13,183 · 10th to 90th $2,512 to $21,380Professionalmedian $1,047 · 10th to 90th $741 to $1,698
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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,071.52 | Professional | None | $741.31 | $741.31 | $1,071.52 |
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 $870.96 Median $1,230.27 Typical High $1,862.09 | Professional | None | $870.96 | $1,230.27 | $1,862.09 |
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 $776.25 Median $954.99 Typical High $1,348.96 | Professional | None | $776.25 | $954.99 | $1,348.96 |
Denver HMP Setting Facility Modifier None Typical Low $741.31 Median $954.99 Typical High $1,548.82 | Facility | None | $741.31 | $954.99 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,380.38 | Professional | None | $691.83 | $912.01 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,943.28 | Facility | None | $691.83 | $1,380.38 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,023.29 | Professional | None | $691.83 | $776.25 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,548.82 | Professional | None | $758.58 | $1,000.00 | $1,548.82 |
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 $371.54 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 53 · Discontinued | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $537.03 |
Where Colorado sits
The same service costs 6.0 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 $14,230MT $2,377
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.