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 $354.81 Typical High $524.81 | Professional | None | $309.03 | $354.81 | $524.81 |
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 $363.08 Median $524.81 Typical High $776.25 | Professional | None | $363.08 | $524.81 | $776.25 |
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 $302.00 Median $398.11 Typical High $588.84 | Professional | None | $302.00 | $398.11 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $323.59 Median $416.87 Typical High $741.31 | Facility | None | $323.59 | $416.87 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $691.83 | Professional | None | $371.54 | $501.19 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $812.83 | Facility | None | $208.93 | $389.05 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $489.78 | Professional | None | $323.59 | $389.05 | $489.78 |
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 $309.03 Median $407.38 Typical High $676.08 | Professional | None | $309.03 | $407.38 | $676.08 |
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 $162.18 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $162.18 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $64.57 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $245.47 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $229.09 | $234.42 | $245.47 |
Where Colorado sits
The same service costs 5.9 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
$457
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.