How much rates vary
Facilitymedian $4,365 · 10th to 90th $933 to $8,511Professionalmedian $363 · 10th to 90th $209 to $692
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 $295.12 Median $3,090.30 Typical High $7,762.47 | Facility | None | $295.12 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $645.65 | Professional | None | $186.21 | $416.87 | $645.65 |
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 $223.87 Median $309.03 Typical High $457.09 | Professional | None | $223.87 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,288.25 Typical High $1,819.70 | Facility | None | $575.44 | $1,288.25 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $724.44 | Professional | None | $257.04 | $446.68 | $724.44 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $426.58 Typical High $645.65 | Facility | None | $186.21 | $426.58 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $776.25 | Professional | None | $208.93 | $389.05 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $891.25 Typical High $1,584.89 | Facility | None | $346.74 | $891.25 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $478.63 | Professional | None | $190.55 | $229.09 | $478.63 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,762.47 | Facility | None | $1,288.25 | $2,511.89 | $7,762.47 |
United Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $776.25 | Professional | None | $257.04 | $457.09 | $776.25 |
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 $93.33 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $93.33 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $37.15 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $141.25 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $28.18 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $18.62 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $131.83 | $251.19 | $302.00 |
Where Colorado sits
The same service costs 4.6 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 $4,728MT $1,029
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.