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 $371.54 Median $457.09 Typical High $501.19 | Professional | None | $371.54 | $457.09 | $501.19 |
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 $416.87 Median $602.56 Typical High $891.25 | Professional | None | $416.87 | $602.56 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,089.30 Typical High $2,818.38 | Facility | None | $588.84 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $831.76 | Professional | None | $426.58 | $562.34 | $831.76 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $537.03 Typical High $794.33 | Facility | None | $371.54 | $537.03 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $851.14 | Professional | None | $416.87 | $588.84 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $2,454.71 | Facility | None | $501.19 | $912.01 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $512.86 | Professional | None | $363.08 | $446.68 | $512.86 |
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 $426.58 Median $562.34 Typical High $933.25 | Professional | None | $426.58 | $562.34 | $933.25 |
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 $186.21 Median $229.09 Typical High $234.42 | Professional | 52 · Reduced service | $186.21 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $91.20 Typical High $93.33 | Professional | 53 · Discontinued | $74.13 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $346.74 Typical High $354.81 | Professional | 54 · Surgery only | $275.42 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $45.71 Typical High $46.77 | Professional | 56 · Pre-op care only | $37.15 | $45.71 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $323.59 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $257.04 | $323.59 | $331.13 |
Where Colorado sits
The same service costs 6.0 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· 17th of 51
$617
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.