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 $251.19 Median $257.04 Typical High $257.04 | Professional | None | $251.19 | $257.04 | $257.04 |
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 $281.84 Median $407.38 Typical High $602.56 | Professional | None | $281.84 | $407.38 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,230.27 Typical High $1,659.59 | Facility | None | $436.52 | $1,230.27 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $436.52 | Professional | None | $223.87 | $288.40 | $436.52 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $302.00 Typical High $562.34 | Facility | None | $239.88 | $302.00 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $512.86 | Professional | None | $281.84 | $363.08 | $512.86 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $512.86 Typical High $1,445.44 | Facility | None | $281.84 | $512.86 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $380.19 | Professional | None | $251.19 | $281.84 | $380.19 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $501.19 | Professional | None | $223.87 | $295.12 | $501.19 |
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 $125.89 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $50.12 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $38.90 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $173.78 | $177.83 | $177.83 |
Where Colorado sits
The same service costs 5.4 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· 14th of 51
$363
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.