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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $371.54 | Professional | None | $239.88 | $363.08 | $371.54 |
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 $275.42 Median $380.19 Typical High $575.44 | Professional | None | $275.42 | $380.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,090.30 | Facility | None | $588.84 | $2,187.76 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $616.60 | Professional | None | $269.15 | $398.11 | $616.60 |
Denver HMP Setting Facility Modifier None Typical Low $239.88 Median $371.54 Typical High $549.54 | Facility | None | $239.88 | $371.54 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $630.96 | Professional | None | $275.42 | $407.38 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $2,754.23 | Facility | None | $371.54 | $691.83 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $371.54 | Professional | None | $234.42 | $295.12 | $371.54 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $691.83 | Professional | None | $263.03 | $407.38 | $691.83 |
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 $120.23 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $120.23 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $177.83 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.99 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $165.96 | $234.42 | $257.04 |
Where Colorado sits
The same service costs 5.5 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· 22nd of 51
$417
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.