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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $2,570.40 | Professional | None | $346.74 | $363.08 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,585.78 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $912.01 | Professional | None | $436.52 | $616.60 | $912.01 |
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 $398.11 Median $524.81 Typical High $724.44 | Professional | None | $398.11 | $524.81 | $724.44 |
Denver HMP Setting Facility Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Facility | None | $346.74 | $467.74 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $478.63 Typical High $707.95 | Professional | None | $331.13 | $478.63 | $707.95 |
Select Health Setting Facility Modifier None Typical Low $331.13 Median $676.08 Typical High $5,011.87 | Facility | None | $331.13 | $676.08 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $645.65 | Professional | None | $234.42 | $331.13 | $645.65 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $851.14 | Professional | None | $416.87 | $537.03 | $851.14 |
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 $173.78 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $288.40 |
Where Colorado sits
The same service costs 9.3 times more in Kansas 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· 15th of 51
$741
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.