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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $436.52 | Professional | None | $218.78 | $218.78 | $436.52 |
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 $257.04 Median $338.84 Typical High $478.63 | Professional | None | $257.04 | $338.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $3,090.30 | Facility | None | $436.52 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $524.81 | Professional | None | $257.04 | $407.38 | $524.81 |
Denver HMP Setting Facility Modifier None Typical Low $218.78 Median $309.03 Typical High $549.54 | Facility | None | $218.78 | $309.03 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $436.52 | Professional | None | $218.78 | $275.42 | $436.52 |
Select Health Setting Facility Modifier None Typical Low $158.49 Median $371.54 Typical High $2,691.53 | Facility | None | $158.49 | $371.54 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $371.54 | Professional | None | $181.97 | $213.80 | $371.54 |
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 $257.04 Median $371.54 Typical High $562.34 | Professional | None | $257.04 | $371.54 | $562.34 |
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 $109.65 Median $109.65 Typical High $173.78 | Professional | 52 · Reduced service | $109.65 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $69.18 | Professional | 53 · Discontinued | $43.65 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $263.03 | Professional | 54 · Surgery only | $162.18 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $52.48 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $245.47 |
Where Colorado sits
The same service costs 4.6 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· 27th of 51
$355
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.