How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,148 to $10,965Professionalmedian $417 · 10th to 90th $275 to $676
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 $416.87 Median $3,311.31 Typical High $8,709.64 | Facility | None | $416.87 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $426.58 | Professional | None | $269.15 | $407.38 | $426.58 |
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 $309.03 Median $436.52 Typical High $645.65 | Professional | None | $309.03 | $436.52 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $3,090.30 | Facility | None | $436.52 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $676.08 | Professional | None | $275.42 | $407.38 | $676.08 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $616.60 | Facility | None | $269.15 | $416.87 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $724.44 | Professional | None | $309.03 | $467.74 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $2,754.23 | Facility | None | $426.58 | $794.33 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $426.58 | Professional | None | $269.15 | $331.13 | $426.58 |
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 $288.40 Median $436.52 Typical High $776.25 | Professional | None | $288.40 | $436.52 | $776.25 |
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 $134.90 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $134.90 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $53.70 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $204.17 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $40.74 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $26.92 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $190.55 | $263.03 | $295.12 |
Where Colorado sits
The same service costs 6.2 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 $6,171MT $1,002
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.