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 $457.09 Median $457.09 Typical High $6,456.54 | Professional | None | $457.09 | $457.09 | $6,456.54 |
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 $436.52 Median $575.44 Typical High $912.01 | Professional | None | $436.52 | $575.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $6,760.83 | Facility | None | $891.25 | $3,090.30 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $794.33 | Professional | None | $457.09 | $588.84 | $794.33 |
Denver HMP Setting Facility Modifier None Typical Low $457.09 Median $478.63 Typical High $891.25 | Facility | None | $457.09 | $478.63 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $741.31 | Professional | None | $338.84 | $501.19 | $741.31 |
Select Health Setting Facility Modifier None Typical Low $354.81 Median $707.95 Typical High $3,467.37 | Facility | None | $354.81 | $707.95 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $354.81 | Professional | None | $251.19 | $251.19 | $354.81 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,000.00 | Professional | None | $501.19 | $645.65 | $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 $218.78 Median $229.09 Typical High $302.00 | Professional | 52 · Reduced service | $218.78 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $120.23 | Professional | 53 · Discontinued | $87.10 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $323.59 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $416.87 |
Where Colorado sits
The same service costs 5.5 times more in Alaska than in Kentucky. 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· 3rd of 51
$1,995
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.