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 $707.95 Median $707.95 Typical High $724.44 | Professional | None | $707.95 | $707.95 | $724.44 |
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 $812.83 Median $1,148.15 Typical High $1,737.80 | Professional | None | $812.83 | $1,148.15 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,677.35 Typical High $7,079.46 | Facility | None | $812.83 | $4,677.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,288.25 | Professional | None | $724.44 | $891.25 | $1,288.25 |
Denver HMP Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $1,513.56 | Facility | None | $707.95 | $933.25 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,348.96 | Professional | None | $660.69 | $891.25 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $6,165.95 | Facility | None | $660.69 | $1,412.54 | $6,165.95 |
Select Health Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,000.00 | Professional | None | $660.69 | $741.31 | $1,000.00 |
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 $724.44 Median $933.25 Typical High $1,445.44 | Professional | None | $724.44 | $933.25 | $1,445.44 |
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 $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Where Colorado sits
The same service costs 8.7 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· 16th of 51
$1,175
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.