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 $269.15 Median $354.81 Typical High $416.87 | Professional | None | $269.15 | $354.81 | $416.87 |
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 $331.13 Median $501.19 Typical High $758.58 | Professional | None | $331.13 | $501.19 | $758.58 |
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 $295.12 Median $389.05 Typical High $588.84 | Professional | None | $295.12 | $389.05 | $588.84 |
Denver HMP Setting Facility Modifier None Typical Low $275.42 Median $407.38 Typical High $630.96 | Facility | None | $275.42 | $407.38 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $660.69 | Professional | None | $302.00 | $457.09 | $660.69 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $2,454.71 | Facility | None | $380.19 | $707.95 | $2,454.71 |
Select Health Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $489.78 | Professional | None | $223.87 | $323.59 | $489.78 |
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 $302.00 Median $416.87 Typical High $660.69 | Professional | None | $302.00 | $416.87 | $660.69 |
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 $138.04 Median $169.82 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $204.17 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.88 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $239.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $190.55 | $239.88 | $269.15 |
Where Colorado sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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
$447
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.