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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | None | $426.58 | $426.58 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,023.29 | Professional | None | $478.63 | $691.83 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $3,090.30 | Facility | None | $436.52 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $724.44 | Professional | None | $398.11 | $489.78 | $724.44 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $912.01 | Facility | None | $380.19 | $501.19 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $831.76 | Professional | None | $407.38 | $549.54 | $831.76 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $831.76 Typical High $2,754.23 | Facility | None | $407.38 | $831.76 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $616.60 | Professional | None | $407.38 | $446.68 | $616.60 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $2,951.21 | Facility | None | $489.78 | $1,174.90 | $2,951.21 |
United Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $851.14 | Professional | None | $380.19 | $512.86 | $851.14 |
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 $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $208.93 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $295.12 |
Where Colorado sits
The same service costs 8.1 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· 13th of 51
$676
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.