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 $602.56 Median $724.44 Typical High $724.44 | Professional | None | $602.56 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,479.11 | Professional | None | $691.83 | $1,000.00 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $2,187.76 | Facility | None | $588.84 | $1,000.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,230.27 | Professional | None | $588.84 | $794.33 | $1,230.27 |
Denver HMP Setting Facility Modifier None Typical Low $602.56 Median $812.83 Typical High $1,318.26 | Facility | None | $602.56 | $812.83 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,288.25 | Professional | None | $707.95 | $933.25 | $1,288.25 |
Select Health Setting Facility Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,584.89 | Facility | None | $758.58 | $1,096.48 | $1,584.89 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $870.96 | Professional | None | $588.84 | $758.58 | $870.96 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,380.38 | Professional | None | $588.84 | $794.33 | $1,380.38 |
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 $302.00 Median $346.74 Typical High $363.08 | Professional | 52 · Reduced service | $302.00 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $489.78 | $501.19 |
Where Colorado sits
The same service costs 5.6 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
$912
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.