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 $288.40 Median $426.58 Typical High $512.86 | Professional | None | $288.40 | $426.58 | $512.86 |
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 $338.84 Median $467.74 Typical High $691.83 | Professional | None | $338.84 | $467.74 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $524.81 Typical High $2,691.53 | Facility | None | $354.81 | $524.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $724.44 | Professional | None | $316.23 | $436.52 | $724.44 |
Denver HMP Setting Facility Modifier None Typical Low $288.40 Median $436.52 Typical High $645.65 | Facility | None | $288.40 | $436.52 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $758.58 | Professional | None | $331.13 | $489.78 | $758.58 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $457.09 Typical High $933.25 | Facility | None | $426.58 | $457.09 | $933.25 |
Select Health Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $446.68 | Professional | None | $288.40 | $354.81 | $446.68 |
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 $467.74 Typical High $812.83 | Professional | None | $309.03 | $467.74 | $812.83 |
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 $144.54 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $144.54 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $57.54 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $218.78 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $43.65 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.84 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $204.17 | $281.84 | $302.00 |
Where Colorado sits
The same service costs 4.7 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
$479
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.