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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $954.99 | Professional | None | $933.25 | $933.25 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $7,585.78 Typical High $13,182.57 | Facility | None | $4,897.79 | $7,585.78 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,513.56 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $11,481.54 Typical High $18,197.01 | Facility | None | $812.83 | $11,481.54 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,584.89 | Professional | None | $851.14 | $1,071.52 | $1,584.89 |
Denver HMP Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,949.84 | Facility | None | $933.25 | $1,122.02 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,737.80 | Professional | None | $870.96 | $1,148.15 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $870.96 Median $1,819.70 Typical High $15,848.93 | Facility | None | $870.96 | $1,819.70 | $15,848.93 |
Select Health Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,288.25 | Professional | None | $870.96 | $977.24 | $1,288.25 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,862.09 | Professional | None | $812.83 | $1,122.02 | $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 $467.74 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $660.69 |
Where Colorado sits
The same service costs 16.2 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· 14th 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.