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 $1,202.26 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,202.26 | $1,202.26 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,548.82 | $1,584.89 |
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 $1,380.38 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,949.84 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $2,691.53 | Facility | None | $758.58 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,862.09 | $2,691.53 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $2,570.40 | Facility | None | $1,202.26 | $2,041.74 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,905.46 | $2,754.23 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $3,467.37 | Facility | None | $1,230.27 | $1,659.59 | $3,467.37 |
Select Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,380.38 | $1,659.59 |
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 $1,949.84 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,949.84 | $3,090.30 |
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 $602.56 Median $776.25 Typical High $794.33 | Professional | 52 · Reduced service | $602.56 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $239.88 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $234.42 Typical High $239.88 | Professional | 55 · Aftercare only | $181.97 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $154.88 Typical High $158.49 | Professional | 56 · Pre-op care only | $120.23 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,096.48 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $831.76 | $1,096.48 | $1,122.02 |
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· 23rd of 51
$1,950
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.