How much rates vary
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 $269.15 Median $3,235.94 Typical High $9,120.11 | Facility | None | $269.15 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $407.38 | Professional | None | $186.21 | $269.15 | $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 $218.78 Median $331.13 Typical High $602.56 | Professional | None | $218.78 | $331.13 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,187.76 | Facility | None | $588.84 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $398.11 | Professional | None | $194.98 | $269.15 | $398.11 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $407.38 | Facility | None | $186.21 | $269.15 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $478.63 | Professional | None | $190.55 | $302.00 | $478.63 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $524.81 Typical High $1,230.27 | Facility | None | $281.84 | $524.81 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $281.84 | Professional | None | $123.03 | $218.78 | $281.84 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $501.19 | Professional | None | $204.17 | $295.12 | $501.19 |
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 $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $93.33 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $37.15 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $204.17 | Professional | 54 · Surgery only | $141.25 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $18.62 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $162.18 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $131.83 | $162.18 | $190.55 |
Where Colorado sits
The same service costs 4.2 times more in Alaska than in Utah. 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.
Colorado· 16th of 51
$347
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.