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 $954.99 Median $3,235.94 Typical High $8,912.51 | Facility | None | $954.99 | $3,235.94 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,230.27 | Professional | None | $776.25 | $954.99 | $1,230.27 |
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 $891.25 Median $1,230.27 Typical High $2,089.30 | Professional | None | $891.25 | $1,230.27 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,659.59 Typical High $2,691.53 | Facility | None | $691.83 | $1,659.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,412.54 | Professional | None | $851.14 | $1,023.29 | $1,412.54 |
Denver HMP Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,380.38 | Facility | None | $776.25 | $1,122.02 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,621.81 | Professional | None | $691.83 | $1,122.02 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $1,995.26 | Facility | None | $954.99 | $1,737.80 | $1,995.26 |
Select Health Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $954.99 | Professional | None | $467.74 | $831.76 | $954.99 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,778.28 | Professional | None | $831.76 | $1,096.48 | $1,778.28 |
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 $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $676.08 |
Where Colorado sits
The same service costs 4.4 times more in Alaska than in Texas. 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· 13th of 51
$1,202
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.