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 $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | None | $616.60 | $616.60 | $758.58 |
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 $707.95 Median $1,000.00 Typical High $1,479.11 | Professional | None | $707.95 | $1,000.00 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $691.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,174.90 | Professional | None | $630.96 | $776.25 | $1,174.90 |
Denver HMP Setting Facility Modifier None Typical Low $616.60 Median $851.14 Typical High $1,318.26 | Facility | None | $616.60 | $851.14 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,174.90 | Professional | None | $588.84 | $776.25 | $1,174.90 |
Select Health Setting Facility Modifier None Typical Low $588.84 Median $1,174.90 Typical High $2,754.23 | Facility | None | $588.84 | $1,174.90 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $870.96 | Professional | None | $588.84 | $645.65 | $870.96 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,479.11 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,230.27 | Professional | None | $630.96 | $812.83 | $1,230.27 |
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 $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Where Colorado sits
The same service costs 7.4 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· 19th of 51
$1,000
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.