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 $691.83 Median $3,235.94 Typical High $8,912.51 | Facility | None | $691.83 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $758.58 | Professional | None | $489.78 | $660.69 | $758.58 |
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 $562.34 Median $794.33 Typical High $1,174.90 | Professional | None | $562.34 | $794.33 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $288.40 Typical High $2,691.53 | Facility | None | $165.96 | $288.40 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,174.90 | Professional | None | $616.60 | $794.33 | $1,174.90 |
Denver HMP Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,071.52 | Facility | None | $489.78 | $831.76 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,202.26 | Professional | None | $512.86 | $794.33 | $1,202.26 |
Select Health Setting Facility Modifier None Typical Low $199.53 Median $724.44 Typical High $1,548.82 | Facility | None | $199.53 | $724.44 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $724.44 | Professional | None | $478.63 | $562.34 | $724.44 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,862.09 | Facility | None | $239.88 | $616.60 | $1,862.09 |
United Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,348.96 | Professional | None | $588.84 | $812.83 | $1,348.96 |
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 $245.47 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $245.47 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $97.72 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $72.44 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $48.98 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $338.84 | $446.68 | $489.78 |
Where Colorado sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 23rd of 51
$794
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.