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 $1,659.59 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,659.59 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $562.34 | Professional | None | $371.54 | $512.86 | $562.34 |
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 $426.58 Median $602.56 Typical High $891.25 | Professional | None | $426.58 | $602.56 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,148.15 Typical High $3,311.31 | Facility | None | $794.33 | $1,148.15 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $870.96 | Professional | None | $407.38 | $562.34 | $870.96 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $549.54 Typical High $794.33 | Facility | None | $371.54 | $549.54 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $891.25 | Professional | None | $416.87 | $602.56 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $524.81 Median $977.24 Typical High $1,230.27 | Facility | None | $524.81 | $977.24 | $1,230.27 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $524.81 | Professional | None | $363.08 | $457.09 | $524.81 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $1,000.00 | Professional | None | $407.38 | $575.44 | $1,000.00 |
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 $186.21 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $186.21 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $74.13 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $275.42 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $54.95 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $257.04 | $338.84 | $363.08 |
Where Colorado sits
The same service costs 4.8 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· 20th of 51
$617
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.