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 $371.54 Median $3,162.28 Typical High $9,549.93 | Facility | None | $371.54 | $3,162.28 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $676.08 | Professional | None | $331.13 | $371.54 | $676.08 |
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 $426.58 Median $602.56 Typical High $891.25 | Professional | None | $426.58 | $602.56 | $891.25 |
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 $398.11 Median $549.54 Typical High $758.58 | Professional | None | $398.11 | $549.54 | $758.58 |
Denver HMP Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $562.34 | Facility | None | $331.13 | $467.74 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $758.58 | Professional | None | $354.81 | $537.03 | $758.58 |
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 $234.42 Median $426.58 Typical High $831.76 | Professional | None | $234.42 | $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 $426.58 Median $537.03 Typical High $851.14 | Professional | None | $426.58 | $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 $162.18 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $162.18 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $245.47 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $302.00 |
Where Colorado sits
The same service costs 3.8 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· 12th of 51
$661
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.