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 $1,258.93 Median $3,388.44 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,388.44 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $457.09 | Professional | None | $234.42 | $323.59 | $457.09 |
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 $281.84 Median $416.87 Typical High $758.58 | Professional | None | $281.84 | $416.87 | $758.58 |
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 $251.19 Median $346.74 Typical High $512.86 | Professional | None | $251.19 | $346.74 | $512.86 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $346.74 Typical High $489.78 | Facility | None | $239.88 | $346.74 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $602.56 | Professional | None | $229.09 | $371.54 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $645.65 Typical High $1,230.27 | Facility | None | $346.74 | $645.65 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $346.74 | Professional | None | $144.54 | $257.04 | $346.74 |
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 $263.03 Median $371.54 Typical High $616.60 | Professional | None | $263.03 | $371.54 | $616.60 |
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 $120.23 Median $144.54 Typical High $173.78 | Professional | 52 · Reduced service | $120.23 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $218.78 Typical High $257.04 | Professional | 54 · Surgery only | $181.97 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $204.17 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $169.82 | $204.17 | $239.88 |
Where Colorado sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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
$447
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.