How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,288 to $8,913Professionalmedian $269 · 10th to 90th $182 to $427
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 $309.03 Median $3,388.44 Typical High $9,120.11 | Facility | None | $309.03 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $977.24 | Professional | None | $169.82 | $186.21 | $977.24 |
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 $213.80 Median $302.00 Typical High $436.52 | Professional | None | $213.80 | $302.00 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,311.31 | Facility | None | $588.84 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $354.81 | Professional | None | $199.53 | $263.03 | $354.81 |
Denver HMP Setting Facility Modifier None Typical Low $169.82 Median $234.42 Typical High $331.13 | Facility | None | $169.82 | $234.42 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $346.74 | Professional | None | $165.96 | $234.42 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $331.13 Typical High $2,884.03 | Facility | None | $165.96 | $331.13 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $323.59 | Professional | None | $114.82 | $165.96 | $323.59 |
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 $208.93 Median $263.03 Typical High $416.87 | Professional | None | $208.93 | $263.03 | $416.87 |
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 $85.11 Median $85.11 Typical High $100.00 | Professional | 52 · Reduced service | $85.11 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | 53 · Discontinued | $33.88 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 54 · Surgery only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $141.25 |
Where Colorado sits
The same service costs 8.1 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 $4,634MT $570
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.