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 $1,995.26 Median $3,715.35 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,715.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,621.81 | $2,089.30 |
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 $1,819.70 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,630.27 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,786.30 Typical High $7,244.36 | Facility | None | $812.83 | $4,786.30 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,659.59 | $2,041.74 | $3,019.95 |
Denver HMP Setting Facility Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,388.44 | Facility | None | $1,621.81 | $2,089.30 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,949.84 | $2,951.21 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $3,090.30 Typical High $6,309.57 | Facility | None | $1,479.11 | $3,090.30 | $6,309.57 |
Select Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,698.24 | $2,187.76 |
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 $1,621.81 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,137.96 | $3,235.94 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Colorado sits
The same service costs 19.5 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
$2,630
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.