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 $2,570.40 Median $5,495.41 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | None | $501.19 | $501.19 | $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 $575.44 Median $794.33 Typical High $1,202.26 | Professional | None | $575.44 | $794.33 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,801.89 Typical High $5,754.40 | Facility | None | $933.25 | $3,801.89 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $977.24 | Professional | None | $549.54 | $660.69 | $977.24 |
Denver HMP Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $1,047.13 | Facility | None | $501.19 | $707.95 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $912.01 | Professional | None | $457.09 | $616.60 | $912.01 |
Select Health Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $5,011.87 | Facility | None | $457.09 | $912.01 | $5,011.87 |
Select Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $691.83 | Professional | None | $457.09 | $524.81 | $691.83 |
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 $524.81 Median $691.83 Typical High $1,148.15 | Professional | None | $524.81 | $691.83 | $1,148.15 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Colorado sits
The same service costs 18.2 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· 17th of 51
$832
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.