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 $616.60 Median $758.58 Typical High $1,023.29 | Professional | None | $616.60 | $758.58 | $1,023.29 |
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 $724.44 Median $1,023.29 Typical High $1,737.80 | Professional | None | $724.44 | $1,023.29 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,584.89 Typical High $2,187.76 | Facility | None | $588.84 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,148.15 | Professional | None | $660.69 | $812.83 | $1,148.15 |
Denver HMP Setting Facility Modifier None Typical Low $630.96 Median $891.25 Typical High $1,148.15 | Facility | None | $630.96 | $891.25 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,380.38 | Professional | None | $575.44 | $933.25 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $1,862.09 | Facility | None | $812.83 | $1,479.11 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $380.19 Median $676.08 Typical High $812.83 | Professional | None | $380.19 | $676.08 | $812.83 |
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 $660.69 Median $870.96 Typical High $1,412.54 | Professional | None | $660.69 | $870.96 | $1,412.54 |
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 $309.03 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $549.54 |
Where Colorado sits
The same service costs 4.2 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· 12th of 51
$1,023
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.