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 $398.11 Median $3,235.94 Typical High $9,120.11 | Facility | None | $398.11 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $512.86 | Professional | None | $316.23 | $380.19 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $870.96 | Professional | None | $363.08 | $512.86 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $2,454.71 | Facility | None | $588.84 | $1,778.28 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $575.44 | Professional | None | $338.84 | $416.87 | $575.44 |
Denver HMP Setting Facility Modifier None Typical Low $323.59 Median $467.74 Typical High $575.44 | Facility | None | $323.59 | $467.74 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $691.83 | Professional | None | $302.00 | $489.78 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $2,089.30 | Facility | None | $407.38 | $758.58 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $407.38 | Professional | None | $199.53 | $354.81 | $407.38 |
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 $346.74 Median $446.68 Typical High $741.31 | Professional | None | $346.74 | $446.68 | $741.31 |
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 $162.18 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $162.18 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $79.43 | Professional | 53 · Discontinued | $64.57 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $52.48 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $39.81 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $245.47 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $223.87 | $245.47 | $275.42 |
Where Colorado sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 15th of 51
$525
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.