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 $1,148.15 Median $3,388.44 Typical High $8,709.64 | Facility | None | $1,148.15 | $3,388.44 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $5,495.41 | Professional | None | $562.34 | $575.44 | $5,495.41 |
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 $575.44 Median $812.83 Typical High $1,202.26 | Professional | None | $575.44 | $812.83 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,698.24 Typical High $3,235.94 | Facility | None | $436.52 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $977.24 | Professional | None | $549.54 | $724.44 | $977.24 |
Denver HMP Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $977.24 | Facility | None | $575.44 | $691.83 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $977.24 | Professional | None | $457.09 | $645.65 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $2,884.03 | Facility | None | $457.09 | $912.01 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $891.25 | Professional | None | $323.59 | $457.09 | $891.25 |
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 $575.44 Median $741.31 Typical High $1,148.15 | Professional | None | $575.44 | $741.31 | $1,148.15 |
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 $257.04 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $446.68 |
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· 11th of 51
$1,000
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.