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 $416.87 Median $446.68 Typical High $457.09 | Professional | None | $416.87 | $446.68 | $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 $457.09 Median $660.69 Typical High $1,000.00 | Professional | None | $457.09 | $660.69 | $1,000.00 |
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 $389.05 Median $512.86 Typical High $758.58 | Professional | None | $389.05 | $512.86 | $758.58 |
Denver HMP Setting Facility Modifier None Typical Low $416.87 Median $524.81 Typical High $891.25 | Facility | None | $416.87 | $524.81 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $851.14 | Professional | None | $467.74 | $616.60 | $851.14 |
Select Health Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,445.44 | Facility | None | $501.19 | $912.01 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $602.56 | Professional | None | $407.38 | $501.19 | $602.56 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,995.26 | Facility | None | $239.88 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $870.96 | Professional | None | $389.05 | $524.81 | $870.96 |
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 $208.93 Median $218.78 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $309.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $316.23 |
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· 16th of 51
$589
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.