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 $380.19 Median $3,235.94 Typical High $8,912.51 | Facility | None | $380.19 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $478.63 | Professional | None | $281.84 | $302.00 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $616.60 | Professional | None | $331.13 | $446.68 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,630.78 Typical High $5,754.40 | Facility | None | $691.83 | $3,630.78 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $524.81 | Professional | None | $316.23 | $363.08 | $524.81 |
Denver HMP Setting Facility Modifier None Typical Low $302.00 Median $389.05 Typical High $660.69 | Facility | None | $302.00 | $389.05 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $588.84 | Professional | None | $295.12 | $371.54 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $263.03 Median $524.81 Typical High $5,011.87 | Facility | None | $263.03 | $524.81 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $489.78 | Professional | None | $251.19 | $295.12 | $489.78 |
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 $295.12 Median $363.08 Typical High $588.84 | Professional | None | $295.12 | $363.08 | $588.84 |
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 $141.25 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $57.54 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $213.80 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $199.53 | $208.93 | $245.47 |
Where Colorado sits
The same service costs 5.5 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· 21st of 51
$417
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.