How much rates vary
Facilitymedian $10,000 · 10th to 90th $1,288 to $21,380Professionalmedian $631 · 10th to 90th $447 to $1,047
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 $1,479.11 Median $3,715.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,715.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $660.69 | Professional | None | $436.52 | $602.56 | $660.69 |
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 $501.19 Median $707.95 Typical High $1,047.13 | Professional | None | $501.19 | $707.95 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $9,332.54 | Facility | None | $691.83 | $4,786.30 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,023.29 | Professional | None | $478.63 | $660.69 | $1,023.29 |
Denver HMP Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $954.99 | Facility | None | $436.52 | $630.96 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,071.52 | Professional | None | $501.19 | $724.44 | $1,071.52 |
Select Health Setting Facility Modifier None Typical Low $630.96 Median $1,174.90 Typical High $8,128.31 | Facility | None | $630.96 | $1,174.90 | $8,128.31 |
Select Health Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $630.96 | Professional | None | $436.52 | $537.03 | $630.96 |
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 $467.74 Median $676.08 Typical High $1,148.15 | Professional | None | $467.74 | $676.08 | $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 $218.78 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $218.78 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $87.10 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $331.13 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $66.07 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $309.03 | $389.05 | $426.58 |
Where Colorado sits
The same service costs 7.0 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 $10,631MT $1,524
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.