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 $575.44 Median $3,715.35 Typical High $10,964.78 | Facility | None | $575.44 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $457.09 | Professional | None | $281.84 | $416.87 | $457.09 |
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 $331.13 Median $457.09 Typical High $676.08 | Professional | None | $331.13 | $457.09 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $3,311.31 | Facility | None | $831.76 | $2,344.23 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $724.44 | Professional | None | $331.13 | $467.74 | $724.44 |
Denver HMP Setting Facility Modifier None Typical Low $281.84 Median $416.87 Typical High $645.65 | Facility | None | $281.84 | $416.87 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $707.95 | Professional | None | $323.59 | $478.63 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $2,754.23 | Facility | None | $426.58 | $794.33 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $426.58 | Professional | None | $281.84 | $346.74 | $426.58 |
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 $316.23 Median $478.63 Typical High $831.76 | Professional | None | $316.23 | $478.63 | $831.76 |
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 $141.25 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $141.25 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $77.62 Typical High $85.11 | Professional | 53 · Discontinued | $56.23 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $288.40 Typical High $316.23 | Professional | 54 · Surgery only | $213.80 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $57.54 Typical High $63.10 | Professional | 55 · Aftercare only | $42.66 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $28.18 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $269.15 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $199.53 | $269.15 | $295.12 |
Where Colorado sits
The same service costs 5.9 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· 25th of 51
$490
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.