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 $316.23 Median $3,235.94 Typical High $9,120.11 | Facility | None | $316.23 | $3,235.94 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $380.19 | Professional | None | $234.42 | $309.03 | $380.19 |
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 $281.84 Median $416.87 Typical High $645.65 | Professional | None | $281.84 | $416.87 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $2,187.76 | Facility | None | $588.84 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $489.78 | Professional | None | $245.47 | $331.13 | $489.78 |
Denver HMP Setting Facility Modifier None Typical Low $234.42 Median $331.13 Typical High $512.86 | Facility | None | $234.42 | $331.13 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $549.54 | Professional | None | $245.47 | $380.19 | $549.54 |
Select Health Setting Facility Modifier None Typical Low $316.23 Median $588.84 Typical High $1,096.48 | Facility | None | $316.23 | $588.84 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $398.11 | Professional | None | $190.55 | $269.15 | $398.11 |
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 $251.19 Median $346.74 Typical High $549.54 | Professional | None | $251.19 | $346.74 | $549.54 |
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 $117.49 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $57.54 Typical High $63.10 | Professional | 53 · Discontinued | $46.77 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $218.78 Typical High $239.88 | Professional | 54 · Surgery only | $173.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $34.67 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $204.17 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $162.18 | $204.17 | $223.87 |
Where Colorado sits
The same service costs 4.3 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· 16th of 51
$380
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.