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 $1,174.90 Median $1,174.90 Typical High $1,479.11 | Facility | None | $1,174.90 | $1,174.90 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,479.11 | $1,479.11 |
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 $1,348.96 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,348.96 | $1,905.46 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $2,691.53 | Facility | None | $691.83 | $1,148.15 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,819.70 | $2,570.40 |
Denver HMP Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $2,454.71 | Facility | None | $1,174.90 | $1,905.46 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,819.70 | $2,630.27 |
Select Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $3,235.94 | Facility | None | $1,096.48 | $1,548.82 | $3,235.94 |
Select Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,348.96 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $4,265.80 Typical High $13,489.63 | Facility | None | $1,949.84 | $4,265.80 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,412.54 | $1,862.09 | $2,951.21 |
5 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 $588.84 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $234.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $218.78 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $117.49 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,023.29 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $1,023.29 | $1,047.13 |
Where Colorado sits
The same service costs 5.1 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· 19th of 51
$1,905
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.