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 $380.19 Median $3,235.94 Typical High $10,964.78 | Facility | None | $380.19 | $3,235.94 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $741.31 | Professional | None | $331.13 | $380.19 | $741.31 |
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 $436.52 Median $616.60 Typical High $912.01 | Professional | None | $436.52 | $616.60 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,454.71 Typical High $3,801.89 | Facility | None | $933.25 | $2,454.71 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $776.25 | Professional | None | $380.19 | $549.54 | $776.25 |
Denver HMP Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $562.34 | Facility | None | $331.13 | $478.63 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $776.25 | Professional | None | $363.08 | $549.54 | $776.25 |
Select Health Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $2,884.03 | Facility | None | $426.58 | $794.33 | $2,884.03 |
Select Health Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $831.76 | Professional | None | $239.88 | $426.58 | $831.76 |
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 $416.87 Median $549.54 Typical High $870.96 | Professional | None | $416.87 | $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 $165.96 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $251.19 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $234.42 | $269.15 | $309.03 |
Where Colorado sits
The same service costs 4.3 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
$676
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.