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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $4,365.16 | Professional | None | $891.25 | $954.99 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $2,290.87 | Professional | None | $977.24 | $1,318.26 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,691.53 | Facility | None | $691.83 | $1,778.28 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,479.11 | Professional | None | $912.01 | $1,122.02 | $1,479.11 |
Denver HMP Setting Facility Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,380.38 | Facility | None | $954.99 | $1,174.90 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,698.24 | Professional | None | $851.14 | $1,174.90 | $1,698.24 |
Select Health Setting Facility Modifier None Typical Low $851.14 Median $1,698.24 Typical High $2,089.30 | Facility | None | $851.14 | $1,698.24 | $2,089.30 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,202.26 | Professional | None | $602.56 | $851.14 | $1,202.26 |
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 $954.99 Median $1,174.90 Typical High $1,862.09 | Professional | None | $954.99 | $1,174.90 | $1,862.09 |
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 $436.52 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $676.08 |
Where Colorado sits
The same service costs 7.1 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
$1,585
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.