How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,512 to $17,783Professionalmedian $1,318 · 10th to 90th $891 to $2,089
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 $1,288.25 Median $3,981.07 Typical High $10,964.78 | Facility | None | $1,288.25 | $3,981.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $2,754.23 | Professional | None | $831.76 | $891.25 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,479.11 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $4,365.16 Typical High $6,760.83 | Facility | None | $1,778.28 | $4,365.16 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,737.80 | Professional | None | $977.24 | $1,288.25 | $1,737.80 |
Denver HMP Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,621.81 | Facility | None | $831.76 | $1,148.15 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,698.24 | Professional | None | $812.83 | $1,148.15 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $1,621.81 Typical High $5,011.87 | Facility | None | $812.83 | $1,621.81 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,584.89 | Professional | None | $562.34 | $812.83 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $5,754.40 Typical High $13,489.63 | Facility | None | $1,949.84 | $5,754.40 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,318.26 | $2,089.30 |
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 $416.87 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $707.95 |
Where Colorado sits
The same service costs 4.2 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 $11,551MT $2,762
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.