How much rates vary
Facilitymedian $13,183 · 10th to 90th $2,512 to $21,380Professionalmedian $759 · 10th to 90th $550 to $1,230
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 $549.54 Median $549.54 Typical High $691.83 | Professional | None | $549.54 | $549.54 | $691.83 |
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 $630.96 Median $891.25 Typical High $1,348.96 | Professional | None | $630.96 | $891.25 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,466.84 Typical High $7,079.46 | Facility | None | $691.83 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $954.99 | Professional | None | $549.54 | $676.08 | $954.99 |
Denver HMP Setting Facility Modifier None Typical Low $549.54 Median $724.44 Typical High $1,174.90 | Facility | None | $549.54 | $724.44 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,047.13 | Professional | None | $524.81 | $691.83 | $1,047.13 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $6,165.95 | Facility | None | $524.81 | $1,047.13 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $794.33 | Professional | None | $524.81 | $575.44 | $794.33 |
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 $537.03 Median $707.95 Typical High $1,096.48 | Professional | None | $537.03 | $707.95 | $1,096.48 |
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 $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $389.05 |
Where Colorado sits
The same service costs 7.9 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 $13,941MT $1,762
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.