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 $1,479.11 Median $3,715.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,715.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $457.09 | Professional | None | $331.13 | $436.52 | $457.09 |
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 $380.19 Median $549.54 Typical High $812.83 | Professional | None | $380.19 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $2,818.38 | Facility | None | $691.83 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $741.31 | Professional | None | $346.74 | $489.78 | $741.31 |
Denver HMP Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $676.08 | Facility | None | $331.13 | $478.63 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $776.25 | Professional | None | $363.08 | $524.81 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $2,454.71 | Facility | None | $457.09 | $851.14 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $457.09 | Professional | None | $331.13 | $389.05 | $457.09 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $831.76 | Professional | None | $346.74 | $489.78 | $831.76 |
7 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 $165.96 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $165.96 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $66.07 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $251.19 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $316.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $467.74 Typical High $707.95 | Professional | 50 · Both sides | $331.13 | $467.74 | $707.95 |
Where Colorado sits
The same service costs 5.0 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· 18th of 51
$550
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.