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 $371.54 Median $575.44 Typical High $630.96 | Professional | None | $371.54 | $575.44 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $9,549.93 Typical High $16,218.10 | Facility | None | $6,165.95 | $9,549.93 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $870.96 | Professional | None | $416.87 | $588.84 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $5,754.40 | Facility | None | $588.84 | $2,951.21 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $1,230.27 | Professional | None | $416.87 | $707.95 | $1,230.27 |
Denver HMP Setting Facility Modifier None Typical Low $371.54 Median $630.96 Typical High $954.99 | Facility | None | $371.54 | $630.96 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $1,096.48 | Professional | None | $407.38 | $660.69 | $1,096.48 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,230.27 Typical High $5,011.87 | Facility | None | $660.69 | $1,230.27 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $660.69 | Professional | None | $363.08 | $446.68 | $660.69 |
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 $407.38 Median $724.44 Typical High $1,230.27 | Professional | None | $407.38 | $724.44 | $1,230.27 |
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 $181.97 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $181.97 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $74.13 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $275.42 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $54.95 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $37.15 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $257.04 | $389.05 | $446.68 |
Where Colorado sits
The same service costs 4.9 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· 21st of 51
$708
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.