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 $138.04 Median $194.98 Typical High $234.42 | Professional | None | $138.04 | $194.98 | $234.42 |
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 $147.91 Median $186.21 Typical High $316.23 | Professional | None | $147.91 | $186.21 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,659.59 Typical High $2,398.83 | Facility | None | $436.52 | $1,659.59 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $295.12 | Professional | None | $128.82 | $186.21 | $295.12 |
Denver HMP Setting Facility Modifier None Typical Low $154.88 Median $223.87 Typical High $338.84 | Facility | None | $154.88 | $223.87 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $316.23 | Professional | None | $141.25 | $204.17 | $316.23 |
Select Health Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $2,089.30 | Facility | None | $204.17 | $380.19 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $204.17 | Professional | None | $81.28 | $138.04 | $204.17 |
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 $131.83 Median $204.17 Typical High $338.84 | Professional | None | $131.83 | $204.17 | $338.84 |
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 $77.62 Median $81.28 Typical High $117.49 | Professional | 52 · Reduced service | $77.62 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $24.55 Typical High $35.48 | Professional | 55 · Aftercare only | $23.44 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.49 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $114.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $109.65 | $114.82 | $162.18 |
Where Colorado sits
The same service costs 4.7 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· 18th of 51
$234
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.