How much rates vary
Facilitymedian $12,882 · 10th to 90th $2,239 to $21,380Professionalmedian $1,202 · 10th to 90th $871 to $1,995
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 $1,122.02 Median $3,235.94 Typical High $8,912.51 | Facility | None | $1,122.02 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,380.38 | Professional | None | $870.96 | $870.96 | $1,380.38 |
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 $1,000.00 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,445.44 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,677.35 Typical High $9,120.11 | Facility | None | $691.83 | $4,677.35 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,513.56 | Professional | None | $891.25 | $1,071.52 | $1,513.56 |
Denver HMP Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,905.46 | Facility | None | $870.96 | $1,148.15 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,698.24 | Professional | None | $831.76 | $1,122.02 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $1,698.24 Typical High $7,943.28 | Facility | None | $831.76 | $1,698.24 | $7,943.28 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,258.93 | Professional | None | $831.76 | $912.01 | $1,258.93 |
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 $851.14 Median $1,122.02 Typical High $1,778.28 | Professional | None | $851.14 | $1,122.02 | $1,778.28 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Colorado sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.