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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $489.78 | Professional | None | $398.11 | $407.38 | $489.78 |
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 $446.68 Median $645.65 Typical High $954.99 | Professional | None | $446.68 | $645.65 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,466.84 Typical High $7,079.46 | Facility | None | $691.83 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $707.95 | Professional | None | $380.19 | $489.78 | $707.95 |
Denver HMP Setting Facility Modifier None Typical Low $407.38 Median $489.78 Typical High $891.25 | Facility | None | $407.38 | $489.78 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $794.33 | Professional | None | $398.11 | $524.81 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $398.11 Median $794.33 Typical High $6,165.95 | Facility | None | $398.11 | $794.33 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $588.84 | Professional | None | $398.11 | $416.87 | $588.84 |
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 $371.54 Median $501.19 Typical High $794.33 | Professional | None | $371.54 | $501.19 | $794.33 |
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 $199.53 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $281.84 |
Where Colorado sits
The same service costs 7.2 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· 15th of 51
$661
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.