How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,413 to $8,913Professionalmedian $708 · 10th to 90th $490 to $1,096
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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $2,570.40 | Professional | None | $446.68 | $562.34 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,174.90 | Professional | None | $562.34 | $794.33 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $2,818.38 | Facility | None | $588.84 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $870.96 | Professional | None | $446.68 | $630.96 | $870.96 |
Denver HMP Setting Facility Modifier None Typical Low $478.63 Median $562.34 Typical High $1,122.02 | Facility | None | $478.63 | $562.34 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $933.25 | Professional | None | $446.68 | $630.96 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $891.25 Typical High $2,454.71 | Facility | None | $446.68 | $891.25 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $870.96 | Professional | None | $316.23 | $446.68 | $870.96 |
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 $478.63 Median $616.60 Typical High $1,000.00 | Professional | None | $478.63 | $616.60 | $1,000.00 |
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 $245.47 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $389.05 | $389.05 |
Where Colorado sits
The same service costs 3.6 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 $5,175MT $1,450
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.