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 $812.83 Median $3,235.94 Typical High $10,715.19 | Facility | None | $812.83 | $3,235.94 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,047.13 | Professional | None | $660.69 | $812.83 | $1,047.13 |
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 $758.58 Median $1,047.13 Typical High $1,778.28 | Professional | None | $758.58 | $1,047.13 | $1,778.28 |
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 $707.95 Median $870.96 Typical High $1,174.90 | Professional | None | $707.95 | $870.96 | $1,174.90 |
Denver HMP Setting Facility Modifier None Typical Low $660.69 Median $954.99 Typical High $1,174.90 | Facility | None | $660.69 | $954.99 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,380.38 | Professional | None | $602.56 | $977.24 | $1,380.38 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $1,513.56 Typical High $1,862.09 | Facility | None | $812.83 | $1,513.56 | $1,862.09 |
Select Health Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $812.83 | Professional | None | $398.11 | $707.95 | $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 $724.44 Median $912.01 Typical High $1,513.56 | Professional | None | $724.44 | $912.01 | $1,513.56 |
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 $323.59 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $323.59 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $562.34 |
Where Colorado sits
The same service costs 4.5 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
$1,047
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.