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 $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $549.54 | Professional | None | $281.84 | $380.19 | $549.54 |
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 $331.13 Median $489.78 Typical High $891.25 | Professional | None | $331.13 | $489.78 | $891.25 |
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 $302.00 Median $407.38 Typical High $588.84 | Professional | None | $302.00 | $407.38 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $575.44 | Facility | None | $288.40 | $407.38 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $691.83 | Professional | None | $263.03 | $426.58 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $741.31 Typical High $1,230.27 | Facility | None | $407.38 | $741.31 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $407.38 | Professional | None | $169.82 | $302.00 | $407.38 |
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 $309.03 Median $436.52 Typical High $724.44 | Professional | None | $309.03 | $436.52 | $724.44 |
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 $144.54 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $144.54 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $57.54 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $251.19 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $50.12 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.84 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $281.84 |
Where Colorado sits
The same service costs 3.9 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· 13th 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.