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 $2,691.53 Median $5,495.41 Typical High $12,882.50 | Facility | None | $2,691.53 | $5,495.41 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $933.25 | Professional | None | $758.58 | $758.58 | $933.25 |
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 $851.14 Median $1,230.27 Typical High $1,862.09 | Professional | None | $851.14 | $1,230.27 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,168.69 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,348.96 | Professional | None | $724.44 | $891.25 | $1,348.96 |
Denver HMP Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $1,621.81 | Facility | None | $758.58 | $933.25 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,445.44 | Professional | None | $707.95 | $954.99 | $1,445.44 |
Select Health Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $5,011.87 | Facility | None | $707.95 | $1,445.44 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,071.52 | Professional | None | $707.95 | $776.25 | $1,071.52 |
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 $691.83 Median $954.99 Typical High $1,513.56 | Professional | None | $691.83 | $954.99 | $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 $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where Colorado sits
The same service costs 17.4 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· 12th of 51
$1,230
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.