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 $537.03 Median $3,235.94 Typical High $8,912.51 | Facility | None | $537.03 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $537.03 | Professional | None | $354.81 | $436.52 | $537.03 |
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 $331.13 Median $416.87 Typical High $724.44 | Professional | None | $331.13 | $416.87 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $3,801.89 | Facility | None | $954.99 | $1,621.81 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $691.83 | Professional | None | $295.12 | $436.52 | $691.83 |
Denver HMP Setting Facility Modifier None Typical Low $354.81 Median $537.03 Typical High $776.25 | Facility | None | $354.81 | $537.03 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $724.44 | Professional | None | $323.59 | $478.63 | $724.44 |
Select Health Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $1,819.70 | Facility | None | $478.63 | $891.25 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $478.63 | Professional | None | $190.55 | $309.03 | $478.63 |
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 $295.12 Median $478.63 Typical High $831.76 | Professional | None | $295.12 | $478.63 | $831.76 |
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 $177.83 Median $199.53 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $199.53 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $79.43 Typical High $107.15 | Professional | 53 · Discontinued | $70.79 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $407.38 | Professional | 54 · Surgery only | $263.03 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $81.28 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $39.81 Typical High $53.70 | Professional | 56 · Pre-op care only | $35.48 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $380.19 |
Where Colorado sits
The same service costs 5.5 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· 17th of 51
$550
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.