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 $309.03 Median $346.74 Typical High $478.63 | Professional | None | $309.03 | $346.74 | $478.63 |
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 $354.81 Median $512.86 Typical High $758.58 | Professional | None | $354.81 | $512.86 | $758.58 |
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 $288.40 Median $380.19 Typical High $588.84 | Professional | None | $288.40 | $380.19 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $316.23 Median $407.38 Typical High $707.95 | Facility | None | $316.23 | $407.38 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $676.08 | Professional | None | $363.08 | $489.78 | $676.08 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $794.33 | Facility | None | $208.93 | $380.19 | $794.33 |
Select Health Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | None | $316.23 | $380.19 | $478.63 |
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 $295.12 Median $389.05 Typical High $660.69 | Professional | None | $295.12 | $389.05 | $660.69 |
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 $158.49 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $158.49 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $63.10 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $245.47 Typical High $257.04 | Professional | 54 · Surgery only | $239.88 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $229.09 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $223.87 | $229.09 | $239.88 |
Where Colorado sits
The same service costs 5.8 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· 17th of 51
$447
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.