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 $602.56 Median $3,235.94 Typical High $10,715.19 | Facility | None | $602.56 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $870.96 | Professional | None | $524.81 | $602.56 | $870.96 |
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 $537.03 Median $707.95 Typical High $1,202.26 | Professional | None | $537.03 | $707.95 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $524.81 Typical High $1,659.59 | Facility | None | $371.54 | $524.81 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $891.25 | Professional | None | $512.86 | $676.08 | $891.25 |
Denver HMP Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $1,096.48 | Facility | None | $549.54 | $831.76 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $870.96 | Professional | None | $489.78 | $645.65 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $537.03 Typical High $1,122.02 | Facility | None | $457.09 | $537.03 | $1,122.02 |
Select Health Setting Professional Modifier None Typical Low $309.03 Median $512.86 Typical High $645.65 | Professional | None | $309.03 | $512.86 | $645.65 |
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 $524.81 Median $691.83 Typical High $1,023.29 | Professional | None | $524.81 | $691.83 | $1,023.29 |
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 $257.04 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $389.05 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $416.87 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $363.08 | $416.87 | $426.58 |
Where Colorado sits
The same service costs 6.2 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
$741
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.