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 $398.11 Median $3,235.94 Typical High $8,912.51 | Facility | None | $398.11 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $537.03 | Professional | None | $288.40 | $371.54 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $758.58 | Professional | None | $338.84 | $446.68 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $575.44 Typical High $2,187.76 | Facility | None | $380.19 | $575.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $537.03 | Professional | None | $269.15 | $371.54 | $537.03 |
Denver HMP Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $691.83 | Facility | None | $338.84 | $407.38 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $562.34 | Professional | None | $316.23 | $416.87 | $562.34 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $501.19 Typical High $724.44 | Facility | None | $346.74 | $501.19 | $724.44 |
Select Health Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $416.87 | Professional | None | $199.53 | $323.59 | $416.87 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,754.23 | Facility | None | $489.78 | $1,122.02 | $2,754.23 |
United Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $645.65 | Professional | None | $288.40 | $389.05 | $645.65 |
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 $154.88 Median $186.21 Typical High $199.53 | Professional | 52 · Reduced service | $154.88 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $63.10 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $46.77 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.90 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $257.04 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $218.78 | $257.04 | $275.42 |
Where Colorado sits
The same service costs 5.8 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· 18th of 51
$457
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.