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 $1,659.59 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,659.59 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $676.08 | Professional | None | $467.74 | $549.54 | $676.08 |
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 $478.63 Median $630.96 Typical High $1,071.52 | Professional | None | $478.63 | $630.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,621.81 Typical High $3,311.31 | Facility | None | $831.76 | $1,621.81 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $851.14 | Professional | None | $426.58 | $549.54 | $851.14 |
Denver HMP Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $977.24 | Facility | None | $524.81 | $676.08 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $891.25 | Professional | None | $457.09 | $630.96 | $891.25 |
Select Health Setting Facility Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,819.70 | Facility | None | $575.44 | $1,071.52 | $1,819.70 |
Select Health Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $575.44 | Professional | None | $275.42 | $457.09 | $575.44 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $7,585.78 | Facility | None | $1,288.25 | $2,511.89 | $7,585.78 |
United Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $1,023.29 | Professional | None | $446.68 | $616.60 | $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 $239.88 Median $257.04 Typical High $323.59 | Professional | 52 · Reduced service | $239.88 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $128.82 | Professional | 53 · Discontinued | $95.50 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $389.05 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $97.72 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $64.57 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $457.09 |
Where Colorado sits
The same service costs 6.5 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· 16th of 51
$724
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.