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 $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
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 $1,122.02 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,548.82 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $3,311.31 | Facility | None | $831.76 | $2,344.23 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,778.28 | Professional | None | $977.24 | $1,202.26 | $1,778.28 |
Denver HMP Setting Facility Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,995.26 | Facility | None | $954.99 | $1,288.25 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,778.28 | Professional | None | $891.25 | $1,174.90 | $1,778.28 |
Select Health Setting Facility Modifier None Typical Low $891.25 Median $1,778.28 Typical High $2,754.23 | Facility | None | $891.25 | $1,778.28 | $2,754.23 |
Select Health Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,348.96 | Professional | None | $891.25 | $1,000.00 | $1,348.96 |
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 $977.24 Median $1,258.93 Typical High $1,995.26 | Professional | None | $977.24 | $1,258.93 | $1,995.26 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $676.08 |
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· 13th of 51
$1,585
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.