How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,148 to $8,913Professionalmedian $288 · 10th to 90th $186 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 $389.05 Median $3,235.94 Typical High $9,120.11 | Facility | None | $389.05 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $407.38 | Professional | None | $186.21 | $275.42 | $407.38 |
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 $204.17 Median $269.15 Typical High $446.68 | Professional | None | $204.17 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $2,187.76 | Facility | None | $588.84 | $1,548.82 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $478.63 | Professional | None | $181.97 | $281.84 | $478.63 |
Denver HMP Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $562.34 | Facility | None | $218.78 | $371.54 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $524.81 | Professional | None | $194.98 | $323.59 | $524.81 |
Select Health Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $1,819.70 | Facility | None | $323.59 | $645.65 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $346.74 | Professional | None | $112.20 | $190.55 | $346.74 |
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 $186.21 Median $323.59 Typical High $575.44 | Professional | None | $186.21 | $323.59 | $575.44 |
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 $138.04 Typical High $194.98 | Professional | 52 · Reduced service | $107.15 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $204.17 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $190.55 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $151.36 | $190.55 | $275.42 |
Where Colorado sits
The same service costs 6.3 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 $4,654MT $736
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.