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 $2,187.76 Median $3,981.07 Typical High $10,964.78 | Facility | None | $2,187.76 | $3,981.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $645.65 | Professional | None | $295.12 | $354.81 | $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 $302.00 Median $398.11 Typical High $676.08 | Professional | None | $302.00 | $398.11 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $354.81 Typical High $1,659.59 | Facility | None | $229.09 | $354.81 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $616.60 Typical High $891.25 | Professional | None | $316.23 | $616.60 | $891.25 |
Denver HMP Setting Facility Modifier None Typical Low $316.23 Median $501.19 Typical High $891.25 | Facility | None | $316.23 | $501.19 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $489.78 | Professional | None | $269.15 | $371.54 | $489.78 |
Select Health Setting Facility Modifier None Typical Low $281.84 Median $309.03 Typical High $645.65 | Facility | None | $281.84 | $309.03 | $645.65 |
Select Health Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $354.81 | Professional | None | $169.82 | $281.84 | $354.81 |
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 $309.03 Median $562.34 Typical High $933.25 | Professional | None | $309.03 | $562.34 | $933.25 |
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 $147.91 Median $162.18 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $74.13 | Professional | 53 · Discontinued | $58.88 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $223.87 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $37.15 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $208.93 | $229.09 | $263.03 |
Where Colorado sits
The same service costs 5.0 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· 14th of 51
$562
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.