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 $851.14 Median $851.14 Typical High $1,047.13 | Professional | None | $851.14 | $851.14 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $15,135.61 Typical High $25,703.96 | Facility | None | $10,000.00 | $15,135.61 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,041.74 | Professional | None | $954.99 | $1,380.38 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $4,466.84 Typical High $7,079.46 | Facility | None | $831.76 | $4,466.84 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,479.11 | Professional | None | $851.14 | $1,023.29 | $1,479.11 |
Denver HMP Setting Facility Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,778.28 | Facility | None | $851.14 | $1,096.48 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,584.89 | Professional | None | $794.33 | $1,047.13 | $1,584.89 |
Select Health Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $6,165.95 | Facility | None | $794.33 | $1,584.89 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,174.90 | Professional | None | $794.33 | $870.96 | $1,174.90 |
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 $812.83 Median $1,071.52 Typical High $1,698.24 | Professional | None | $812.83 | $1,071.52 | $1,698.24 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $588.84 |
Where Colorado sits
The same service costs 7.6 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· 12th of 51
$1,380
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.