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 $323.59 Median $3,090.30 Typical High $8,912.51 | Facility | None | $323.59 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $537.03 | Professional | None | $251.19 | $389.05 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $891.25 | Professional | None | $295.12 | $501.19 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $2,691.53 | Facility | None | $512.86 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $588.84 | Professional | None | $288.40 | $416.87 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $251.19 Median $407.38 Typical High $575.44 | Facility | None | $251.19 | $407.38 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $691.83 | Professional | None | $257.04 | $407.38 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $851.14 | Facility | None | $407.38 | $630.96 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $407.38 | Professional | None | $151.36 | $263.03 | $407.38 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $724.44 | Professional | None | $269.15 | $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 $125.89 Median $165.96 Typical High $204.17 | Professional | 52 · Reduced service | $125.89 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $66.07 Typical High $81.28 | Professional | 53 · Discontinued | $50.12 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $251.19 Typical High $302.00 | Professional | 54 · Surgery only | $186.21 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $50.12 Typical High $60.26 | Professional | 55 · Aftercare only | $38.02 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.11 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.12 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $234.42 | $281.84 |
Where Colorado sits
The same service costs 3.3 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· 10th of 51
$490
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.