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 $275.42 Median $331.13 Typical High $416.87 | Professional | None | $275.42 | $331.13 | $416.87 |
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 $316.23 Median $446.68 Typical High $794.33 | Professional | None | $316.23 | $446.68 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $245.47 Typical High $446.68 | Facility | None | $52.48 | $245.47 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $537.03 | Professional | None | $309.03 | $380.19 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $524.81 | Facility | None | $275.42 | $398.11 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $616.60 | Professional | None | $245.47 | $389.05 | $616.60 |
Select Health Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $758.58 | Facility | None | $295.12 | $363.08 | $758.58 |
Select Health Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $363.08 | Professional | None | $158.49 | $281.84 | $363.08 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $660.69 | Professional | None | $302.00 | $407.38 | $660.69 |
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 $138.04 Median $158.49 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $54.95 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $208.93 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $257.04 |
Where Colorado sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 11th 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.