How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $11,482Professionalmedian $550 · 10th to 90th $380 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 $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 $371.54 Median $537.03 Typical High $660.69 | Professional | None | $371.54 | $537.03 | $660.69 |
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 $426.58 Median $602.56 Typical High $912.01 | Professional | None | $426.58 | $602.56 | $912.01 |
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 $549.54 Typical High $912.01 | Professional | None | $380.19 | $549.54 | $912.01 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $537.03 Typical High $851.14 | Facility | None | $371.54 | $537.03 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $954.99 | Professional | None | $426.58 | $645.65 | $954.99 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $1,071.52 Typical High $2,754.23 | Facility | None | $588.84 | $1,071.52 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $588.84 | Professional | None | $363.08 | $467.74 | $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 $588.84 Typical High $1,023.29 | Professional | None | $398.11 | $588.84 | $1,023.29 |
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 $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $74.13 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $275.42 | $380.19 | $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 $37.15 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $37.15 | $51.29 | $53.70 |
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 4.8 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 $1,344
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.