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 $912.01 Median $912.01 Typical High $1,174.90 | Professional | None | $912.01 | $912.01 | $1,174.90 |
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 $1,047.13 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,479.11 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $5,754.40 | Facility | None | $758.58 | $3,715.35 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,584.89 | Professional | None | $912.01 | $1,122.02 | $1,584.89 |
Denver HMP Setting Facility Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,905.46 | Facility | None | $912.01 | $1,174.90 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,659.59 | Professional | None | $831.76 | $1,122.02 | $1,659.59 |
Select Health Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $5,011.87 | Facility | None | $831.76 | $1,659.59 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,258.93 | Professional | None | $831.76 | $954.99 | $1,258.93 |
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 $891.25 Median $1,202.26 Typical High $1,862.09 | Professional | None | $891.25 | $1,202.26 | $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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $645.65 |
Where Colorado sits
The same service costs 20.0 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
$1,514
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.