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 $1,258.93 Median $3,548.13 Typical High $9,120.11 | Facility | None | $1,258.93 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $645.65 | Professional | None | $338.84 | $416.87 | $645.65 |
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 $380.19 Median $501.19 Typical High $851.14 | Professional | None | $380.19 | $501.19 | $851.14 |
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 $323.59 Median $426.58 Typical High $616.60 | Professional | None | $323.59 | $426.58 | $616.60 |
Denver HMP Setting Facility Modifier None Typical Low $407.38 Median $478.63 Typical High $776.25 | Facility | None | $407.38 | $478.63 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $630.96 | Professional | None | $346.74 | $489.78 | $630.96 |
Select Health Setting Facility Modifier None Typical Low $407.38 Median $501.19 Typical High $851.14 | Facility | None | $407.38 | $501.19 | $851.14 |
Select Health Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $457.09 | Professional | None | $218.78 | $363.08 | $457.09 |
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 $338.84 Median $457.09 Typical High $758.58 | Professional | None | $338.84 | $457.09 | $758.58 |
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 $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $83.18 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $295.12 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $251.19 | $295.12 | $323.59 |
Where Colorado sits
The same service costs 5.6 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· 17th of 51
$525
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.