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 $380.19 Median $407.38 Typical High $436.52 | Professional | None | $380.19 | $407.38 | $436.52 |
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 $426.58 Median $616.60 Typical High $912.01 | Professional | None | $426.58 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $302.00 Typical High $1,659.59 | Facility | None | $173.78 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $707.95 | Professional | None | $338.84 | $457.09 | $707.95 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $831.76 | Facility | None | $380.19 | $457.09 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $794.33 | Professional | None | $436.52 | $588.84 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $457.09 Typical High $977.24 | Facility | None | $208.93 | $457.09 | $977.24 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $562.34 | Professional | None | $380.19 | $457.09 | $562.34 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $776.25 | Professional | None | $338.84 | $467.74 | $776.25 |
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 $190.55 Median $199.53 Typical High $208.93 | Professional | 52 · Reduced service | $190.55 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $288.40 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $63.10 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $295.12 |
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· 17th of 51
$537
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.