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 $1,479.11 Median $3,715.35 Typical High $10,715.19 | Facility | None | $1,479.11 | $3,715.35 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $398.11 | Professional | None | $288.40 | $323.59 | $398.11 |
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 $316.23 Median $457.09 Typical High $676.08 | Professional | None | $316.23 | $457.09 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $2,691.53 | Facility | None | $691.83 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $549.54 | Professional | None | $316.23 | $389.05 | $549.54 |
Denver HMP Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $616.60 | Facility | None | $288.40 | $407.38 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $575.44 | Professional | None | $316.23 | $416.87 | $575.44 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $616.60 Typical High $1,445.44 | Facility | None | $331.13 | $616.60 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $407.38 | Professional | None | $281.84 | $331.13 | $407.38 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,413.10 | Facility | None | $1,288.25 | $2,511.89 | $7,413.10 |
United Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $630.96 | Professional | None | $309.03 | $398.11 | $630.96 |
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 $144.54 Median $158.49 Typical High $162.18 | Professional | 52 · Reduced service | $144.54 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $63.10 Typical High $64.57 | Professional | 53 · Discontinued | $57.54 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $31.62 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.84 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $223.87 |
Where Colorado sits
The same service costs 6.8 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· 22nd of 51
$437
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.