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 $954.99 Median $3,311.31 Typical High $8,709.64 | Facility | None | $954.99 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $954.99 | Professional | None | $158.49 | $186.21 | $954.99 |
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 $186.21 Median $263.03 Typical High $389.05 | Professional | None | $186.21 | $263.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $954.99 Typical High $1,659.59 | Facility | None | $436.52 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $338.84 | Professional | None | $165.96 | $239.88 | $338.84 |
Denver HMP Setting Facility Modifier None Typical Low $158.49 Median $204.17 Typical High $295.12 | Facility | None | $158.49 | $204.17 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $346.74 | Professional | None | $158.49 | $239.88 | $346.74 |
Select Health Setting Facility Modifier None Typical Low $194.98 Median $354.81 Typical High $1,096.48 | Facility | None | $194.98 | $354.81 | $1,096.48 |
Select Health Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $380.19 | Professional | None | $104.71 | $194.98 | $380.19 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $371.54 | Professional | None | $169.82 | $229.09 | $371.54 |
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 $79.43 Median $93.33 Typical High $95.50 | Professional | 52 · Reduced service | $79.43 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $37.15 Typical High $38.02 | Professional | 53 · Discontinued | $32.36 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $138.04 Typical High $144.54 | Professional | 54 · Surgery only | $120.23 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $28.84 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.62 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.85 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $134.90 |
Where Colorado sits
The same service costs 4.6 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
$295
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.