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 $1,513.56 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $5,495.41 | Professional | None | $380.19 | $380.19 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,495.41 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,495.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,047.13 | Professional | None | $501.19 | $707.95 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $2,691.53 | Facility | None | $562.34 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $812.83 | Professional | None | $426.58 | $549.54 | $812.83 |
Denver HMP Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $602.56 | Facility | None | $380.19 | $512.86 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $812.83 | Professional | None | $380.19 | $549.54 | $812.83 |
Select Health Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $812.83 | Facility | None | $380.19 | $776.25 | $812.83 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $741.31 | Professional | None | $269.15 | $380.19 | $741.31 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $933.25 | Professional | None | $457.09 | $588.84 | $933.25 |
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 $190.55 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $316.23 |
Where Colorado sits
The same service costs 6.0 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· 6th of 51
$851
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.