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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $380.19 | Professional | None | $269.15 | $371.54 | $380.19 |
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 $309.03 Median $426.58 Typical High $645.65 | Professional | None | $309.03 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $512.86 Typical High $2,691.53 | Facility | None | $331.13 | $512.86 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $645.65 | Professional | None | $295.12 | $416.87 | $645.65 |
Denver HMP Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $575.44 | Facility | None | $269.15 | $416.87 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $660.69 | Professional | None | $302.00 | $446.68 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $436.52 Typical High $831.76 | Facility | None | $398.11 | $436.52 | $831.76 |
Select Health Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $398.11 | Professional | None | $263.03 | $323.59 | $398.11 |
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 $302.00 Median $426.58 Typical High $741.31 | Professional | None | $302.00 | $426.58 | $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 $134.90 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $134.90 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $75.86 | Professional | 53 · Discontinued | $53.70 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $199.53 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $186.21 | $245.47 | $269.15 |
Where Colorado sits
The same service costs 5.2 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· 20th 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.