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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $562.34 | Professional | None | $426.58 | $436.52 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $912.01 | Professional | None | $478.63 | $645.65 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $776.25 | Professional | None | $457.09 | $549.54 | $776.25 |
Denver HMP Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $1,023.29 | Facility | None | $389.05 | $549.54 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $891.25 | Professional | None | $446.68 | $575.44 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $812.83 Typical High $851.14 | Facility | None | $407.38 | $812.83 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $660.69 | Professional | None | $354.81 | $426.58 | $660.69 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $4,786.30 | Facility | None | $660.69 | $1,380.38 | $4,786.30 |
United Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $870.96 | Professional | None | $436.52 | $549.54 | $870.96 |
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 $213.80 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $389.05 | Professional | 54 · Surgery only | $316.23 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $363.08 |
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· 19th of 51
$617
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.