How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,288 to $11,482Professionalmedian $309 · 10th to 90th $234 to $501
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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $2,570.40 | Professional | None | $218.78 | $239.88 | $2,570.40 |
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 $245.47 Median $338.84 Typical High $501.19 | Professional | None | $245.47 | $338.84 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,698.24 Typical High $3,235.94 | Facility | None | $436.52 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $407.38 | Professional | None | $245.47 | $309.03 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $288.40 Typical High $407.38 | Facility | None | $239.88 | $288.40 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $407.38 | Professional | None | $194.98 | $275.42 | $407.38 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $389.05 Typical High $2,884.03 | Facility | None | $194.98 | $389.05 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $380.19 | Professional | None | $138.04 | $194.98 | $380.19 |
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 $239.88 Median $309.03 Typical High $478.63 | Professional | None | $239.88 | $309.03 | $478.63 |
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 $107.15 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $107.15 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $42.66 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $162.18 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.38 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $186.21 |
Where Colorado sits
The same service costs 9.6 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 $6,197MT $647
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.