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 $380.19 Median $549.54 Typical High $660.69 | Professional | None | $380.19 | $549.54 | $660.69 |
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 $446.68 Median $660.69 Typical High $1,202.26 | Professional | None | $446.68 | $660.69 | $1,202.26 |
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 $524.81 Typical High $812.83 | Professional | None | $389.05 | $524.81 | $812.83 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $549.54 Typical High $891.25 | Facility | None | $380.19 | $549.54 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $933.25 | Professional | None | $371.54 | $588.84 | $933.25 |
Select Health Setting Facility Modifier None Typical Low $549.54 Median $1,023.29 Typical High $2,454.71 | Facility | None | $549.54 | $1,023.29 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $549.54 | Professional | None | $239.88 | $426.58 | $549.54 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $954.99 | Professional | None | $398.11 | $575.44 | $954.99 |
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 $190.55 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $190.55 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $77.62 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $288.40 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $57.54 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $371.54 | $407.38 |
Where Colorado sits
The same service costs 4.4 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· 17th 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.