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 $524.81 Median $3,235.94 Typical High $8,912.51 | Facility | None | $524.81 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $1,348.96 | Professional | None | $416.87 | $512.86 | $1,348.96 |
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 $588.84 Median $2,089.30 Typical High $2,818.38 | Facility | None | $588.84 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $812.83 | Professional | None | $389.05 | $588.84 | $812.83 |
Denver HMP Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $851.14 | Facility | None | $416.87 | $537.03 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $794.33 | Professional | None | $363.08 | $537.03 | $794.33 |
Select Health Setting Facility Modifier None Typical Low $446.68 Median $831.76 Typical High $2,454.71 | Facility | None | $446.68 | $831.76 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $870.96 | Professional | None | $239.88 | $446.68 | $870.96 |
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 $416.87 Median $602.56 Typical High $933.25 | Professional | None | $416.87 | $602.56 | $933.25 |
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 $208.93 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $331.13 | $363.08 |
Where Colorado sits
The same service costs 4.9 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· 12th of 51
$708
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.