How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,445 to $12,882Professionalmedian $708 · 10th to 90th $214 to $1,622
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 $3,630.78 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,630.78 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $812.83 Typical High $1,412.54 | Professional | None | $199.53 | $812.83 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,762.47 Typical High $13,182.57 | Facility | None | $6,165.95 | $7,762.47 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $691.83 Typical High $1,621.81 | Professional | None | $218.78 | $691.83 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,818.38 Typical High $3,890.45 | Facility | None | $588.84 | $2,818.38 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $1,348.96 | Professional | None | $245.47 | $426.58 | $1,348.96 |
Denver HMP Setting Facility Modifier None Typical Low $208.93 Median $794.33 Typical High $1,258.93 | Facility | None | $208.93 | $794.33 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $512.86 Typical High $1,348.96 | Professional | None | $173.78 | $512.86 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $3,388.44 | Facility | None | $331.13 | $1,479.11 | $3,388.44 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $794.33 | Professional | None | $114.82 | $114.82 | $794.33 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,748.98 | Facility | None | $1,479.11 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $251.19 Median $776.25 Typical High $1,513.56 | Professional | None | $251.19 | $776.25 | $1,513.56 |
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 $104.71 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $104.71 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $141.25 Typical High $173.78 | Professional | 53 · Discontinued | $41.69 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $524.81 Typical High $660.69 | Professional | 54 · Surgery only | $154.88 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $104.71 Typical High $131.83 | Professional | 55 · Aftercare only | $31.62 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $70.79 Typical High $87.10 | Professional | 56 · Pre-op care only | $20.89 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $489.78 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $144.54 | $489.78 | $616.60 |
Where Colorado sits
The same service costs 5.1 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 $7,315MT $1,443
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.