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 $302.00 Median $436.52 Typical High $616.60 | Professional | None | $302.00 | $436.52 | $616.60 |
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 $346.74 Median $537.03 Typical High $870.96 | Professional | None | $346.74 | $537.03 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,187.76 Typical High $3,235.94 | Facility | None | $588.84 | $2,187.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $691.83 | Professional | None | $331.13 | $512.86 | $691.83 |
Denver HMP Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $741.31 | Facility | None | $323.59 | $457.09 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $691.83 | Professional | None | $288.40 | $446.68 | $691.83 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $2,884.03 | Facility | None | $407.38 | $758.58 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $181.97 Median $407.38 Typical High $794.33 | Professional | None | $181.97 | $407.38 | $794.33 |
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 $338.84 Median $524.81 Typical High $831.76 | Professional | None | $338.84 | $524.81 | $831.76 |
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 $162.18 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $162.18 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $64.57 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $331.13 | Professional | 54 · Surgery only | $239.88 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $66.07 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $32.36 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $275.42 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $223.87 | $275.42 | $309.03 |
Where Colorado sits
The same service costs 4.8 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· 14th of 51
$589
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.