How much rates vary
Facilitymedian $4,365 · 10th to 90th $676 to $8,511Professionalmedian $240 · 10th to 90th $155 to $407
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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $338.84 | Professional | None | $141.25 | $204.17 | $338.84 |
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 $165.96 Median $263.03 Typical High $446.68 | Professional | None | $165.96 | $263.03 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,513.56 Typical High $2,137.96 | Facility | None | $436.52 | $1,513.56 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $331.13 | Professional | None | $158.49 | $223.87 | $331.13 |
Denver HMP Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $323.59 | Facility | None | $151.36 | $229.09 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $354.81 | Professional | None | $138.04 | $223.87 | $354.81 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $1,862.09 | Facility | None | $208.93 | $389.05 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $407.38 | Professional | None | $87.10 | $208.93 | $407.38 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $389.05 | Professional | None | $154.88 | $234.42 | $389.05 |
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 $75.86 Median $93.33 Typical High $114.82 | Professional | 52 · Reduced service | $75.86 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $37.15 Typical High $45.71 | Professional | 53 · Discontinued | $30.90 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $114.82 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $22.91 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.62 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.14 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $107.15 | $131.83 | $158.49 |
Where Colorado sits
The same service costs 9.9 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 $4,605MT $466
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.